History - Pearson Educationassets.pearsonschool.com/...GCSE-(9-1)-History...Pearson’s brand-new resources* for Edexcel GCSE (9–1) History are designed to help all your students

Edexcel GCSE (9-1) H

istory Medicine through tim

e, c1250–presentPrepare for GCSE from Year 7 with Exploring Science

The front cover shows two astronauts taking photos of each other outside the International Space Station. The mirror-like visor of a space suit is made of polycarbonate plastic polymer coated with gold. The plastic absorbs ultraviolet waves while the gold refl ects infrared and a lot of the visible light waves, reducing the amount of damaging radiation entering an astronaut’s eyes. In Combined Science you will learn about light waves, infrared waves, radiation and why they can be damaging to humans, as well as why polymers and gold have certain special properties.

Edexcel GCSE (9-1) HistoryMedicine through time, c1250–present Series Editor: Angela Leonard

Pearson’s resources are designed to be simple, inclusive and inspiring and to support you in studying for Edexcel GCSE (9-1) Combined Science.

This Student Book uses the Pearson Checkpoint learning approach, which has been designed to help you to develop the skills required for the new assessments.

Checkpoint will help you to understand the key learning for each topic, you can then use this learning to apply, analyse and evaluate in new contexts. This will support you to develop the full range of skills that will be assessed in the exam.

Further key features of the Student Book include:

A Preparing for the Exam section at the end of every Topic, making sure you understand how six mark questions will be assessed

Worked examples for calculations to support you in recalling and applying the Maths elements

Core Practical pages that give you practice answering practical-based exam questions

Every question is rated on a scale of 1 to 12 using the Pearson Steps system, see if you can answer increasingly di� cult questions as you progress through the course.

Foundation: 9781292131559Higher: 9781292131580

Foundation: 9781292131597Higher: 9781292131634

Revise series

Our online ActiveLearn Digital Service, powered by ActiveTeach provides a wealth of teaching, planning and assessment support.

ISBN: 9781292120607

www.pearsonschools.co.uk/KS3ES

ActiveLearn Digital Service

Edexcel GCSE (9-1)

HistorySeries Editor: Angela Leonard Authors: Sally Thorne Hilary Stark

Medicine through time, c1250–present

A LWAY S L E A R N I NG

T 0845 630 33 [email protected]

CVR_HIST_SB_GCSE_7378_CVR.indd 1 23/03/2016 14:31

NEWfor 2016

SAMPLE

MATERIAL

Pearson’s brand-new resources* for Edexcel GCSE (9–1) History are designed to help all your students develop into confident, articulate and successful historians.

With a Student Book and more for every option of the Edexcel GCSE (9–1) History specification, our resources enable you to plan, teach, track and assess the new course with confidence. What’s more, they support success in history for all with a strong focus on key historical skills, exam preparation and practice.

We think our resources speak for themselves! Here’s some hot-off-the-press sample material for you to get a first glimpse of our new resources.

This is from the Edexcel GCSE (9–1) History: Medicine through time, c1250-present, Student Book.

Edexcel GCSE (9–1) History

Supporting great history teaching

*We’re working towards getting these resources endorsed for use with the Edexcel GCSE (9 –1) History specification.

What’s there to see?

3

Introduction 2

Contents 3

Features to look out for... 4–5

Timeline 6–7

Medicine through time, c1250-present Student Book sample chapter 8–33

Writing Historically 34–35

Preparing for your exams 36–37

ActiveLearn Digital Service and Pearson Progression Services 38-39

Next steps 40

Get set for September and save!

35% off our GCSE (9–1) History Student Bookswith code GCSEHIS16**

www.pearsonschools.co.uk/Hist35.

**Valid until 31st May 2016. Only available to those purchasing on a UK establishment account and not to be combined with any other offers.

Features to look out for…

11

1.1 Anglo-Saxon society

Figure 1.3 The powers of Edward the Confessor and the duties of his people. The image in the middle is a representation of Edward’s royal seal. This was attached to his royal orders to show they came from the king.

How powerful was Edward the Confessor?Kings of Anglo-Saxon England held their power ultimately because they led armies. Anglo-Saxon kings had clawed England back from Viking control. Edward the Confessor was not a warrior king, but his earls and their thegns were a powerful military force and he relied on his earls, especially Earl Godwin, to protect England from attack.

Kings who were war leaders gained legitimacy for their rule because they could hand out the wealth and land of their defeated enemies to their followers. When kings did not have success in battle then their power could be reduced. However, Edward had other reasons that made him a legitimate king.

Oath*

A solemn promise to do something. Anglo-Saxons swore oaths on holy relics to make them especially binding. A relic was often a body part of a dead saint, kept in a special casket.

Shire reeve*

An official of the king: his sheriff. Sheriffs managed the king’s estates, collected revenue for him and were in charge of local courts.

Key terms

The power of the English monarchyIn 1060, the king (monarch) was Edward the Confessor. He was the most powerful person in Anglo-Saxon England. He governed the country.

Powers of the king

Law-making: the king created newlaws and made sure they were enforced throughout the country.

Money: the king controlled the production of the silver pennies used as money.

Landownership: the king owned large estates and could grant land out to his followers. He could also take land away from those who had acted against him.

Military power: the king had the ability to raise a national army and fleet.

Taxation: the king decided when taxes should be paid and a national taxation system delivered this tax to him.

Duties of the people

To obey the law as it was passed down through the king’s local representatives.

To use the king’s coins. Forging coins was a very serious crime.

Land carried with it obligations to the king. The main two obligations were payment of tax and military service.

Landholders had to provide and equip fighters for the army or fleet; otherwise they were fined or lost their land.

Landholders had to pay their taxes,otherwise they were fined or lost their land.

The oath sworn by Anglo-Saxon boys once they reached 12 years of age.

All shall swear in the name of the Lord, before whom every holy thing is holy, that they will be faithful to the king… From the day on which this oath shall be rendered, no one shall conceal the breach of it on the part of a brother or family relation, any more than in a stranger.

Source A

The king’s role was to protect his people from attack and give them laws to maintain safety and security at home. In return, the people of England owed him service. Every boy swore an oath* when they reached 12 years of age to be faithful to the king. The oath was administered by the shire reeve* at a special ceremony held each year (see Source A).

01_GCSE_History_Anglo-Saxon_CH01-ccc.indd 11 11/01/2016 15:25

DRAFT

10

1.1 Anglo-Saxon society

EarlsEarls* were the most important aristocrats: the most important men in the country after the king. The relationship between the king and his earls was based on loyalty. The earls competed against each other to be the one the king trusted and relied on the most, so that the king would give them the greatest rewards and honour. Sometimes, earls even challenged the king to get more power.

Earls*

Highest Anglo-Saxon aristocracy. The word came from the Danish ‘jarl’ and meant a chieftain who ruled a region on behalf of the king. The area controlled by an earl is called an earldom.

Key term

Figure 1.2 The main earldoms of England in 1060.

DA

NE

LA

W

Sandwich

Scarborough

CanterburyWinchester

Rhuddlan

Hereford

HastingsPevensey

Oxford

York

LONDON

NORTHUMBRIA

MERCIA

WESSEX

N O R M A N D Y

KENT

EASTANGLIA

Danelaw boundary

River Humber

Changing social statusIn other parts of Europe, such as in Normandy, people’s status in society depended on ancestry: the importance of their family and ancestors. Anglo-Saxon society was much less rigid than this.

• A peasant who prospered and obtained five hides of land that he paid tax on could gain the status of a thegn.

• Merchants who made a number of trips abroad in their own ships could also become thegns.

• Slaves could be freed by their masters – and free peasants could sell themselves into slavery as a desperate measure to feed their families.

• At the top of the social system, thegns could be raised to the status of earls (and earls could be demoted to thegns). Earls could sometimes even become kings.

This question is about identifying key features. You need to identify two relevant points and then develop each point. For example: ‘The social system was not fixed. This meant a free peasant who did very well could become a thegn.’

Exam tip

Describe two features of the social system of Anglo-Saxon England. 4 marks

Exam-style question, Section B

ThegnsThegns were divided into king’s thegns, who held their land direct from the king and served him directly, and those who held their land from earls and other thegns.

When a man became a thegn, he paid a tax called a heriot. Heriot meant ‘war gear’ and the tax required a thegn to equip himself with a helmet and coat of mail, a horse and harness, and a sword and spear.

Extend your knowledge

Anglo-Saxon EnglandThe areas of Britain controlled by Anglo-Saxons had changed over the centuries. Viking invasions had taken control of vast areas, which had then been recaptured. Anglo-Saxon England also had hostile neighbours: Wales, Scotland and Ireland and, to the south, Normandy. The location of Normandy is included on this map, but it was never under Anglo-Saxon control.



DRAFT

Throughout this sample chapter, you’ll get a glimpse of all the features we have created to help all your students succeed in history.

Key TermUnfamiliar and historically important words are defined for students.

Extend your knowledge Extra details to deepen students’ knowledge and understanding.

4

SourcesA wide variety of contemporary sources help bring the subject to life, and give important insight into each period.

Exam-style questionsRealistic exam-style questions appear in every chapter with short tips to help students get started with their answers – ideal for homework and assessments.

ActivitiesEngaging and accessible activities tailored to the skills focuses of each unit to support and stretch students’ learning.

SummaryBullet-point list of the key points from the material at the end of each chunk of learning – great for embedding the core knowledge and handy for revision.

25

1.2 The last years of Edward the Confessor and the succession crisis

The death of Edward the Confessor, portrayed in the Bayeux Tapestry.

Source B

• The house of Godwin had become the real ‘power behind the throne’ in Anglo-Saxon England.

• Harold’s embassy to Normandy and his decisions over Tostig had major consequences.

• Edward the Confessor died childless, causing a succession crisis.

Summary

Strengthen

S1 When did: Harold become Earl of Wessex; Tostig get exiled; King Edward die?

S2 Describe two aspects of the house of Godwin that made them so powerful.

Challenge

C1 In your own words, summarise three reasons why you think Harold went against King Edward’s wishes over the rising against Tostig.

C2 What else would it be useful to know about the consequences of Tostig’s exile?

How confident do you feel about your answers to these questions? If you are not sure that you have answered them well, try the above study skills activity.

Checkpoint

KWL is a strategy to help you take control of your own learning. It stands for Know – Want to know – Learned. This is how it works:

a Draw a table with three columns: ‘Know’, ‘Want to know’, ‘Learned’.

b For any topic you are learning about, write down what you know about it already.

c Next, write down what else you’d like know, what questions you have about what you know.

d When you find out the answers, write them in the ‘Learned’ column.

Use this method to make notes on this section. Here’s an example:

Know Want to know Learned

Tostig was from Wessex; Northumbria was different.

Why was Northumbria different? Part of Northumbria in Danelaw. Different laws, different language, tax lower.

Activity


DRAFTCheckpointStudents are asked to check and reflect on their learning regularly.

‘Strengthen’ sections help consolidate knowledge and understanding.

‘Challenge’ questions encourage evaluation and analysis of what’s being studied.

5

Thinking HistoricallyOur Student Books include ‘Thinking Historically’ activities that target four key strands of understanding: evidence, interpretations, causation & consequence and change & continuity.

These are all based on the ‘Thinking Historically’ approach we’ve developed with Dr Arthur Chapman at the Institute of Education, University College London.

1250 1300 1350 1400 1450 15501500 1600 1650

450-1066 - Anglo-Saxon law enforcement

Late Middle Ages Tudor Stuart

10

Timeline: Medicine

Ideas about causes and prevention

Ideas about treatments

1543Publication of Vesalius’ The Fabric of the Human Body

1676Thomas Sydenham

publishes Observationes Medicae

1485 Battle of Bosworth

1628William Harvey publishes his book on the circulation of the blood

1348Black Death arrives in Britain

c1440Printing press invented

1536: Dissolution of the Monasteries in England

1660Royal Society

meet in London for fi rst time

1665Great Plague arrives

in BritainDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraft

A03_GCSE_History_Medicine_Timeline-cpp.indd 10 15/03/2016 15:05

6

Georgian Victorian World Wars

Edw

ardi

an

Modern EraStuart

11

1700 1800 1900 2000

1909–10Paul Ehrlich discovers the fi rst magic bullet, Salvarsan 606

1917First blood depot is used, at the Battle of Cambrai

1932Discovery of the second magic bullet, Prontosil

1941Florey and Chain develop penicillin into a usable treatment

1928Fleming discovers penicillin

2010 Army 2020

reform

1842William E. Clarke successfully uses

ether to anaesthetise a patient

1847James Simpson discovers chloroform

1854Florence Nightingale treats

wounded soldiers in Crimean War

1907First Aid Nursing Yeomanry (FANY)

founded

1865Joseph Lister uses carbolic acid in

surgeries for fi rst time

1898Royal Army Medical Corps

(RAMC) founded

1895William Roentgen

discovers x-rays

1854John Snow discovers the signifi cance of the Broad Street pump in causing cholera

1803Royal Jennerian Society established

1914Albert Hustin discovers that sodium citrate stops blood from clotting

1915First gas attacks, at Loos, prompt issuing of gas masks

1942National immunisation campaign against diphtheria launched

1901Karl Landsteiner discovers blood groups

1878Pasteur begins his work creating vaccinations

1882: Robert Koch publishes his four hypotheses, and discovers the bacteria causing tuberculosis

1796–98Edward Jenner discovers the

smallpox vaccination

1859Nightingale publishes

Notes on Hospitals

1860Nightingale School for

Nurses established

1861Louis Pasteur discovers

Germ Theory

1953Franklin, Watson and Crick discover the structure of DNA

1914–1918 First World War

1990Human

Genome mapped

1948NHS is

launched

1875Second Public Health Act

1916Battle of the Somme

1956Clean Air Act passed

DraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraft1861

Draft18611861

Draft1861Louis Pasteur discovers

DraftLouis Pasteur discovers Louis Pasteur discovers

DraftLouis Pasteur discovers Louis Pasteur discovers

DraftLouis Pasteur discovers Germ Theory

DraftGerm TheoryGerm Theory



DraftGerm Theory

DraftDraftDraft


1250 1300 1350 1400 1450 15501500 1600 1650

450-1066 - Anglo-Saxon law enforcement

Late Middle Ages Tudor Stuart

10

Timeline: Medicine

Ideas about causes and prevention

Ideas about treatments

1543Publication of Vesalius’ The Fabric of the Human Body

1676Thomas Sydenham

publishes Observationes Medicae

1485 Battle of Bosworth

1628William Harvey publishes his book on the circulation of the blood

1348Black Death arrives in Britain

c1440Printing press invented

1536: Dissolution of the Monasteries in England

1660Royal Society

meet in London for fi rst time

1665Great Plague arrives

in BritainDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraft


7

History Medicine through time, c1250-present Student Book sample chapter

Medieval England was not an easy place to live in. Most of England’s population worked in the fi elds, growing and harvesting crops for wealthy landowners. Poor nutrition, particularly at times of famine when food was scarce, and hard physical labour meant that sickness and disease were never very far away. Some people lived in towns and cities, but this was not much better than the country: the crowded streets and lack of drains meant diseases spread easily. Homes were heated by open fi res, and being exposed to smoke every day meant lung diseases were common. Nearly half of the population died before reaching adulthood.

There wasn’t much scientifi c knowledge in medieval England. In fact, there weren’t many people looking to science to cure diseases and ailments at all. Instead, the Catholic Church used ancient texts, written by leading doctors and physicians such as Hippocrates and Galen, to explain why people caught diseases – or they said it was God’s will when somebody became ill. People believed God could send disease as a punishment for sinful behaviour.

Most of the time, this explanation was enough. Only in times of terrible disease, such as during the Black Death in 1348, did people start to question the authority of the Catholic Church on matters of medicine.

01 c1250–c1500: Medicine in medieval England

By the end of chapter 1, you will:

• understand what ideas people in medieval England had about the causes of disease and illness

• understand what methods medieval people tried in order to prevent and treat disease

• complete a case study on the Black Death, including approaches to its treatment and attempts to prevent it from spreading.

Learning outcomes

Draftnever very far away. Some people lived in towns and cities, but this was not

Draftnever very far away. Some people lived in towns and cities, but this was not much better than the country: the crowded streets and lack of drains meant

Draftmuch better than the country: the crowded streets and lack of drains meant diseases spread easily. Homes were heated by open fi res, and being exposed

Draftdiseases spread easily. Homes were heated by open fi res, and being exposed

Draftto smoke every day meant lung diseases were common. Nearly half of the

Draftto smoke every day meant lung diseases were common. Nearly half of the population died before reaching adulthood.

Draftpopulation died before reaching adulthood.

There wasn’t much scientifi c knowledge in medieval England. In fact, there

Draft There wasn’t much scientifi c knowledge in medieval England. In fact, there weren’t many people looking to science to cure diseases and ailments at all. Draftweren’t many people looking to science to cure diseases and ailments at all. DraftInstead, the Catholic Church used ancient texts, written by leading doctors DraftInstead, the Catholic Church used ancient texts, written by leading doctors and physicians such as Hippocrates and Galen, to explain why people caught

Draftand physicians such as Hippocrates and Galen, to explain why people caught

M01_GCSE_History_Medicine_CH01-cpp.indd 12 15/03/2016 15:02









Learning outcomes












8

13

Supernatural and religious explanations of the causes of disease People in medieval England were very religious. The vast majority of people in England followed the teachings of the Catholic Church. They attended services regularly and were expected to give a sum of money to the Church each month. This was known as a tithe . The Church also owned large amounts of land in England, where it built churches, monasteries and convents. These became important centres of the community: as well as praying, monks and nuns of the Church provided basic medical care, looking a� er people who were not able to care for themselves. The Church used the tithes given by ordinary people to pay for the care of the community.

Illness was not uncommon. Malnutrition*, particularly in times of famine*, made people more likely to fall ill. A lack of scientifi c knowledge at this time meant that the causes of disease and illness were a mystery. The Church tried to use religion to answer the questions people had about illness and disease.

1.1 Ideas about the cause of disease and illness

• Understand di� erent ideas about the cause of disease before 1500, including the Theory of the Four Humours.

• Know the di� erent infl uences on ideas about the cause of disease before 1500.

Learning outcomes

Malnutrition*

Undernourishment due to a lack of food.

Famine*

Food shortage, usually due to bad harvests.

Key term

Ordinary people received most of their teaching from the Church, as they didn’t receive any formal education. The majority of people at this time could not read or write. Instead, they learned from the stories they heard, or the paintings they saw on the wall of their church. One thing they learned was that sin was very dangerous. The Church taught that those who committed a sin could be punished by God. They also taught that the devil could send disease to test someone’s faith, as seen in Source A.

The devil, or Satan, was o� en held responsible for sending diseases to people. This picture is taken from a 12th century manuscript. In the image, Satan is infecting Job. According to the Bible, Job was very obedient and faithful to God. Satan argued that he was only faithful because his life was so good. Infecting him with a disease was used to test his faith.

Source A

Drafttithes given by ordinary people to pay for the care of the community.

Drafttithes given by ordinary people to pay for the care of the community.

Illness was not uncommon. Malnutrition*, particularly in times of famine*,

Draft Illness was not uncommon. Malnutrition*, particularly in times of famine*, made people more likely to fall ill. A lack of scientifi c knowledge at this time

Draftmade people more likely to fall ill. A lack of scientifi c knowledge at this time

Draftmeant that the causes of disease and illness were a mystery. The Church

Draftmeant that the causes of disease and illness were a mystery. The Church tried to use religion to answer the questions people had about illness and

Drafttried to use religion to answer the questions people had about illness and

Draft Ordinary people received most of their teaching from the Church, as they Draft Ordinary people received most of their teaching from the Church, as they


9









Learning outcomes












14


Paralysis*

Being unable to move either all or part of your body as a result of illness, poison or injury.

Key term

This was because it was believed their breath was contagious. Although this was not true (leprosy was spread by very close contact with the infected), it does show that medieval people had some correct ideas about how some diseases were transmitted.

Although there was no formal care for lepers, a few lazar houses did help people su� ering from leprosy. Lazar houses were more commonly known as leper colonies.

A painting of a leper from around 1400. Lepers were made to wear a cloak to cover their diseased bodies and ring a bell to warn people when they were nearby. The bell would also have acted as a way to ask for alms, or charitable donations. The words say, ‘Some good, my gentle master, for God’s sake.’

Source B The Church o� en explained famine by saying that God had sent it as punishment for sin. Therefore, it was logical to also blame people’s sins for their illnesses. This meant that when people recovered, the Church was able to declare that a miracle had happened, thanks to the patient’s prayers. Therefore, blaming sickness on God acted as ‘proof of the divine’: it provided evidence of God’s existence. This explains why the Church supported the idea that God sent disease as a punishment.

Although disease was mainly seen as a result of sin, the Church also taught that disease was sent by God to cleanse one’s soul of sin. If you became ill, God could be sending the illness to purify your soul, or to test your faith, as shown in Source A. Since they had learned that God controlled every aspect of the world, this was very believable to people at this time.

Leprosy The Bible tells many stories of how God sent disease as a punishment – leprosy in particular was included in the Bible as an illustration of a punishment for sin. Leprosy usually began as a painful skin disease, followed by paralysis* and eventually death. Fingers and toes would fall o� , body hair would drop out and ulcers would develop both inside and outside the body.

There was no cure for leprosy, so lepers were banished from their communities. They usually had to move to leper houses or to isolated island communities. If they were allowed to stay in their home towns, they had to wear a cloak and ring a bell to announce their presence, and they were banned from going down narrow alleys, where it was impossible to avoid them.

DraftDrafta punishment – leprosy in particular was included in the

Drafta punishment – leprosy in particular was included in the Bible as an illustration of a punishment for sin. Leprosy

DraftBible as an illustration of a punishment for sin. Leprosy usually began as a painful skin disease, followed by

Draftusually began as a painful skin disease, followed by paralysis* and eventually death. Fingers and toes would Draftparalysis* and eventually death. Fingers and toes would fall o� , body hair would drop out and ulcers would Draftfall o� , body hair would drop out and ulcers would


10

15


Astrology Along with the role of God, the alignment of the planets and stars was also considered very important when diagnosing illness. A physician* would consult star charts, both for when the patient was born and when they fell ill, to help identify what was wrong.

The Theory of the Four Humours Not all explanations for disease were supernatural or religious. A very popular idea, fi rst put forwards by the Ancient Greeks, was the Theory of the Four Humours .

The theory stated that, as the universe was made up of the four basic elements – fi re, water, earth and air – the body must also be made up of four humours, which were all created by digesting di� erent foods. The four humours were:

• blood

• phlegm – the watery substance coughed up or sneezed out of the nose, or expelled in tears

• black bile – not one particular substance in the body, but probably referred to clotted blood, visible in excrement or vomit

• choler , or yellow bile – this appeared in pus or vomit.

There was a belief that all the humours must be balanced and equal. If the mix became unbalanced, you became ill. Being careful to maintain a good balance of the humours was really important to preserving good health. However, people believed a combination of age, family traits and circumstances, such as the season in which someone was born, usually combined to make one or two of the humours stronger than the others.

Traditionally, the Church frowned upon the idea of using astrology in diagnosing illness, as it seemed only one step away from predicting the future, or fortune telling. However, a� er the Black Death arrived, astrology became more popular and the Church became more agreeable to it. Many people believed the Black Death was caused by a bad alignment of the planets.

Astrology was a supernatural explanation for disease. During the period c1250–c1500, the impact of the stars and planets on health was considered important by Hippocrates (see page xx), who was a leading physician from Ancient Greece.

1 Draw a rough outline of a church building. Inside it, list at least three reasons why many people in the Middle Ages believed that the main cause of illness and disease was punishment from God.

2 Write a leafl et in the style of a medieval manuscript, o� ering advice on how to avoid disease and illness.

3 If people believed that God sent disease, what sort of treatments do you think they tried? Make a list – you can see how many you correctly predicted in the next chapter.

Activities Diagnosing illness Physicians considered the patient’s symptoms, as well as star charts, and made a diagnosis (told the patient what was wrong with them) before prescribing a treatment.


Physician*

Someone who practices medicine. A medieval physician did not have to have the same level of training as a modern physician.

Key term

Draftbelieved the Black Death was caused by a bad alignment of the planets.

Draftbelieved the Black Death was caused by a bad alignment of the planets.

Astrology was a supernatural explanation for disease. During the period

Draft Astrology was a supernatural explanation for disease. During the period

Draft The Theory of the Four Humours Draft The Theory of the Four Humours

c1250–c1500, the impact of the stars and planets on health was considered

Draftc1250–c1500, the impact of the stars and planets on health was considered important by Hippocrates (see page xx), who was a leading physician from

Draftimportant by Hippocrates (see page xx), who was a leading physician from


11

17


Galen developed the Theory of the Four Humours to include the idea of balancing the humours by using the Theory of Opposites . For example, he suggested that too much phlegm, which was linked to water and the cold, could be cured by eating hot peppers; a fever, or an excess of blood, could be treated with cucumber, which would cool the patient down when eaten. Galen also theorised that the circulatory system circulated blood generated in the liver, and was then distributed around the body.

Why was the theory so popular? The Theory of the Four Humours was very detailed and could be used to explain away almost any kind of illness – physical or mental. It was important that the theory covered almost every type of illness that occurred, because there was no other scientifi c explanation for the cause of disease. O� en, physicians twisted what they saw to fi t with the logic of the theory.

The origins of the theory The theory was created by an Ancient Greek physician named Hippocrates in the 5th century BCE. The word ‘humour’ comes from the Greek word for fl uid – humon. Hippocrates was very careful to observe all the symptoms of his patients and record them. The Theory of the Four Humours fi tted with what he saw.

Galen, a physician in Ancient Rome during the 2nd century CE, liked the ideas of Hippocrates and developed them further. He had been a physician in a gladiator school and later became the personal physician of the Roman Emperor. This meant that he had lots of time to experiment, ponder philosophy and write. By the time he died, he le� behind a very large body of work – more than 350 books.

Galen’s character Galen had a reputation for being quite arrogant and a ‘know-it-all’. He wrote about this in his works, using himself as an example of how one humour could be more dominant than another. He claimed that he had a naturally choleric temperament, which made him short-tempered. He thought he had inherited this from his mother, who was so bad tempered that she used to bite her servants!


1 Create an advice poster to explain how the Four Humours lead to illness. Make sure you give examples of di� erent illnesses caused by di� erent imbalances.

2 Hippocrates and Galen were both physicians who had a huge impact on medieval medicine. Write a short paragraph to summarise their ideas and explain how Galen built on the work of Hippocrates.

Activities

Draft Galen developed the Theory of the Four Humours to include the idea of Draft Galen developed the Theory of the Four Humours to include the idea of

Theory of OppositesDraftTheory of OppositesDraft

wrote about this in his works, using himself as an example of how one

Draftwrote about this in his works, using himself as an example of how one humour could be more dominant than another. He claimed that he had

Drafthumour could be more dominant than another. He claimed that he had a naturally choleric temperament, which made him short-tempered. He

Drafta naturally choleric temperament, which made him short-tempered. He thought he had inherited this from his mother, who was so bad tempered

Draftthought he had inherited this from his mother, who was so bad tempered that she used to bite her servants!

Draftthat she used to bite her servants!


16


Create a paper fortune teller to help you remember the di erent parts of the Theory of the Four Humours.

a On the outside, write the names of the four humours.

b On the fi rst layer inside, write the characteristics of each humour – hot, cold, wet, dry.

c On the next layer, write anything else that is related to the humour – characteristics, seasons and star signs.

Activity

Figure 1.1 The Four Humours.

Humour Season Element Qualities Ancient name

Blood Spring Air Hot and wet Sanguine

Choler Summer Fire Hot and dry Choleric

Black bile Autumn Earth Cold and dry Melancholic

Phlegm Winter Water Cold and wet Phlegmatic

Blood

WET

DRY

HOT

Spring

Autumn

Air

Earth

Winter

Summer

Fire

Water

COLDBlack bile

Yellowbile

Phlegm

According to the theory, each humour was linked to certain characteristics that physicians would look for when carrying out their diagnosis. For example, a person su ering from a fever had a temperature, causing the skin to go hot and red because, physicians believed, they had too much blood. This was a hot and wet element. Meanwhile, a person su ering from a cold had too much phlegm, which was cold and wet. They would shiver and the excess phlegm would run out of their nose.

The humours were linked with the seasons. For example, in winter, which is cold and wet, the body produces too much phlegm, causing coughs and colds as the patient tried to get rid of it. The star signs for each season were associated with its humour, too: Capricorn, Aquarius and Pisces were linked with phlegm. Astrology was considered an important part of the Theory of the Four Humours, as the humours were connected with star signs and seasons, and each one had its own ruling planet.

The humours were also linked with certain personality traits. For example, a quick tempered, argumentative person was said to have choleric characteristics, while an optimistic, calm person had cheerful tendencies. What we would today recognise as depression was blamed on an excess of black bile.

Draft The Four Humours.

Draft The Four Humours.

DraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraftDraft

Humour

Draft Humour Season

Draft Season

Blood Draft Blood Draft

Spring Draft Spring

Choler Draft Choler

Black bile Draft Black bile

Autumn

DraftAutumn


12

17


Galen developed the Theory of the Four Humours to include the idea of balancing the humours by using the Theory of Opposites . For example, he suggested that too much phlegm, which was linked to water and the cold, could be cured by eating hot peppers; a fever, or an excess of blood, could be treated with cucumber, which would cool the patient down when eaten. Galen also theorised that the circulatory system circulated blood generated in the liver, and was then distributed around the body.

Why was the theory so popular? The Theory of the Four Humours was very detailed and could be used to explain away almost any kind of illness – physical or mental. It was important that the theory covered almost every type of illness that occurred, because there was no other scientifi c explanation for the cause of disease. O� en, physicians twisted what they saw to fi t with the logic of the theory.

The origins of the theory The theory was created by an Ancient Greek physician named Hippocrates in the 5th century BCE. The word ‘humour’ comes from the Greek word for fl uid – humon. Hippocrates was very careful to observe all the symptoms of his patients and record them. The Theory of the Four Humours fi tted with what he saw.

Galen, a physician in Ancient Rome during the 2nd century CE, liked the ideas of Hippocrates and developed them further. He had been a physician in a gladiator school and later became the personal physician of the Roman Emperor. This meant that he had lots of time to experiment, ponder philosophy and write. By the time he died, he le� behind a very large body of work – more than 350 books.

Galen’s character Galen had a reputation for being quite arrogant and a ‘know-it-all’. He wrote about this in his works, using himself as an example of how one humour could be more dominant than another. He claimed that he had a naturally choleric temperament, which made him short-tempered. He thought he had inherited this from his mother, who was so bad tempered that she used to bite her servants!


1 Create an advice poster to explain how the Four Humours lead to illness. Make sure you give examples of di� erent illnesses caused by di� erent imbalances.

2 Hippocrates and Galen were both physicians who had a huge impact on medieval medicine. Write a short paragraph to summarise their ideas and explain how Galen built on the work of Hippocrates.

Activities

Draft Galen developed the Theory of the Four Humours to include the idea of Draft Galen developed the Theory of the Four Humours to include the idea of

Theory of OppositesDraftTheory of OppositesDraft

wrote about this in his works, using himself as an example of how one

Draftwrote about this in his works, using himself as an example of how one humour could be more dominant than another. He claimed that he had

Drafthumour could be more dominant than another. He claimed that he had a naturally choleric temperament, which made him short-tempered. He

Drafta naturally choleric temperament, which made him short-tempered. He thought he had inherited this from his mother, who was so bad tempered

Draftthought he had inherited this from his mother, who was so bad tempered that she used to bite her servants!

Draftthat she used to bite her servants!


13

19


Other ideas about the cause of disease

Miasma A miasma was bad air that was believed to be fi lled with harmful fumes. Hippocrates and Galen both wrote about miasmata (which is the plural of miasma) and suggested that swamps, corpses and other rotting matter could transmit disease.

A picture of a medieval dissection. The physician is sitting high up, away from the body. He is reading aloud from the works of Galen. The body is being dissected by somebody else. This painting appeared in the fi rst illustrated anatomy book to be printed – the Fasciculus Medicinae, written by Joannes de Ketham, an Austrian professor of medicine, in 1491.

Source D

Explain why there was continuity in ideas about the cause of disease during the period c1250–c1500.

You may use the following information in your answer:

• the Church

• a lack of scientifi c understanding.

You must also use information of your own. 12 marks


There are six marks available here for your knowledge and six marks available for how well you can explain your answer.

• Make sure you use your own knowledge as well as what is suggested by the bullet points. If you don’t, you are limiting yourself to a maximum of eight marks.

• The examiner will be looking for structure and coherence. Before you start writing, think carefully about the order of your points and make links between them.

Exam tip

The Romans Over a thousand years before the 13th century, the Romans had built their settlements away from swamps and smelly places in an e� ort to avoid miasmic diseases, such as malaria. Indeed, the word malaria comes from the Italian words ‘mala’ – which means bad, and ‘aria’ – which means air.


Smells and vapours like miasmata were also, unsurprisingly, associated with God. A clean and sweet-smelling home was a sign of spiritual cleanliness, and incense was burned in churches to purify the air. Homes that smelled badly suggested sinfulness and corruption and, if a person was unwashed, other people would avoid them, in case they breathed in the bad miasma and contracted a disease. This was also why people avoided lepers. Although many believed leprosy was a punishment from God, they also believed the disease was contagious.

Draft A

Draft A miasma

Draftmiasma

harmful fumes. Hippocrates and Galen both wrote about

Draftharmful fumes. Hippocrates and Galen both wrote about miasmata (which is the plural of miasma) and suggested

Draftmiasmata (which is the plural of miasma) and suggested that swamps, corpses and other rotting matter could

Draftthat swamps, corpses and other rotting matter could

DraftDraft


18


Classical thinking in the Middle Ages Hippocrates and Galen were both very popular fi gures in medieval medicine. Although written in the time of Ancient Greece and Rome, Latin translations of their texts only started to appear in Europe from the 11th century – almost 800 years a� er they were written. These translations were copied and recopied by monks, who passed them on to new medical universities. The fi rst European medical school had been established in Salerno in the 9th century, and taught students based on these texts, rather than practical experience.

Since books were produced in monasteries, and libraries were maintained by the Church, their choice of texts were the ones that were widely read, preached and believed. In the early Middle Ages, the Church controlled medical learning in universities, too.

The importance of book learning Many people could not read in the Middle Ages. This meant that being widely read was a sign of intelligence. Somebody considered a good physician was one who had read many books, rather than one who had treated a lot of patients. Having read the works of Hippocrates and Galen was proof that a physician was worth the money he was being paid. The authority of these classical texts was so strong that people believed them even when there was actual, physical evidence that suggested they were wrong.

The lack of alternatives There was a lack of scientifi c evidence to support any other kind of theories of the causes of disease. Dissections were mostly illegal, because the Church taught that the body needed to be buried whole in order for the soul to go to heaven. Very occasionally, physicians were able to dissect executed criminals, or criminals who had been sentenced to death by vivisection*. When this happened, the physician would sit far away from the body, reading from the works of Galen, while the actual cutting and examining was done by a barber surgeon*. This meant that Galen’s ideas were preserved: anything in the body that didn’t agree with Galen’s writings could be explained away, since the body was that of a criminal and therefore imperfect, and the physician himself never did any of the examinations.

The Articella By the mid-13th century, medical students in European universities relied on the Articella (or Ars Medicinae) to tell them everything they needed to know about medicine. This medical textbook included some directly translated works from Hippocrates and Galen. It also included the work of a 9th-century Persian doctor, Hunayn ibn-Is’haq al-’Ibadi, who had studied the work of both Hippocrates and Galen at the library of Alexandria. Using them, he wrote a medical manual.


Other classical works were also popular among physicians and medical students, including those of the Greek thinker, Aristotle, and the Persian philosopher and physician, Avicenna. Physicians were expected to have a good background in the liberal arts, such as philosophy, before studying medicine.

However, classical texts like those of Galen continued to be very infl uential in the Middle Ages for three reasons: the infl uence of the Church, the importance of book learning and the lack of alternative theories.

The infl uence of the Church Galen wrote that the body was clearly designed for a purpose and that the di� erent parts of the body were meant to work together in balance, as fi rst proposed by Hippocrates. Galen also believed in the idea of the soul. This theory fi tted in very well with the ideas of the Church, who believed that God created man in his image, and so they promoted Galen’s teachings and, by extension, those of Hippocrates.

Vivisection*

Criminals sentenced to death by vivisection had their bodies cut open (dissected) and examined by physicians and medical students.

Barber surgeon*

Barbers worked with sharp knives, so as well as giving people haircuts, they also carried out medical procedures such as bleeding (see page xx). Over time, they took on smaller surgeries.

Key terms

Draft The lack of alternatives

Draft The lack of alternatives There was a lack of scientifi c evidence to support

Draft There was a lack of scientifi c evidence to support any other kind of theories of the causes of disease.

Draftany other kind of theories of the causes of disease. Dissections were mostly illegal, because the Church

DraftDissections were mostly illegal, because the Church

Draftmedicine. This medical textbook included some directly

Draftmedicine. This medical textbook included some directly translated works from Hippocrates and Galen. It also

Drafttranslated works from Hippocrates and Galen. It also

Draftincluded the work of a 9th-century Persian doctor,

Draftincluded the work of a 9th-century Persian doctor, Hunayn ibn-Is’haq al-’Ibadi, who had studied the DraftHunayn ibn-Is’haq al-’Ibadi, who had studied the work of both Hippocrates and Galen at the library of Draftwork of both Hippocrates and Galen at the library of Alexandria. Using them, he wrote a medical manual. DraftAlexandria. Using them, he wrote a medical manual.


14

19


Other ideas about the cause of disease

Miasma A miasma was bad air that was believed to be fi lled with harmful fumes. Hippocrates and Galen both wrote about miasmata (which is the plural of miasma) and suggested that swamps, corpses and other rotting matter could transmit disease.

A picture of a medieval dissection. The physician is sitting high up, away from the body. He is reading aloud from the works of Galen. The body is being dissected by somebody else. This painting appeared in the fi rst illustrated anatomy book to be printed – the Fasciculus Medicinae, written by Joannes de Ketham, an Austrian professor of medicine, in 1491.

Source D

Explain why there was continuity in ideas about the cause of disease during the period c1250–c1500.


• the Church

• a lack of scientifi c understanding.



There are six marks available here for your knowledge and six marks available for how well you can explain your answer.

• Make sure you use your own knowledge as well as what is suggested by the bullet points. If you don’t, you are limiting yourself to a maximum of eight marks.

• The examiner will be looking for structure and coherence. Before you start writing, think carefully about the order of your points and make links between them.

Exam tip

The Romans Over a thousand years before the 13th century, the Romans had built their settlements away from swamps and smelly places in an e� ort to avoid miasmic diseases, such as malaria. Indeed, the word malaria comes from the Italian words ‘mala’ – which means bad, and ‘aria’ – which means air.


Smells and vapours like miasmata were also, unsurprisingly, associated with God. A clean and sweet-smelling home was a sign of spiritual cleanliness, and incense was burned in churches to purify the air. Homes that smelled badly suggested sinfulness and corruption and, if a person was unwashed, other people would avoid them, in case they breathed in the bad miasma and contracted a disease. This was also why people avoided lepers. Although many believed leprosy was a punishment from God, they also believed the disease was contagious.

Draft A

Draft A miasma

Draftmiasma

harmful fumes. Hippocrates and Galen both wrote about

Draftharmful fumes. Hippocrates and Galen both wrote about miasmata (which is the plural of miasma) and suggested

Draftmiasmata (which is the plural of miasma) and suggested that swamps, corpses and other rotting matter could

Draftthat swamps, corpses and other rotting matter could

DraftDraft


15

21


Attitudes in society Medieval people had a strong belief in God and did not want to risk going to hell by being critical of the Church. Physicians who did not follow the old ideas found it hard to get work, because everybody knew a ‘good’ physician would follow the Theory of the Four Humours. A famous 13 th -century military surgeon, Henri de Mondeville, was among those who questioned the old ways of practising medicine. Mondeville is even quoted as stating that classical fi gures like Hippocrates and Galen were like an old dog that needed to be put down, but whose owner could not face replacing it with a younger, healthier dog. However, even he continued to practise medicine in the same way as everybody else – he probably wouldn’t have found employment otherwise.

Many people believed that, since medicine had always been done this way, there was no need to change it now.

This activity will help you to decide the importance of each key idea about the cause of illness in the years c1250–c1500.

a On slips of paper, write down the key ideas about the causes of illness at this time: God; imbalanced humours; miasma; alignment of the planets/stars.

b Now put these into a hierarchy. Which do you think was the most important? Which was the least important? Do we still believe any of them today? Were some of these ideas more important to particular groups of people, or at di� erent times?

c Look back over the information in this section if you need to jog your memory. Discuss your ideas with another person or in a small group.

Activity

• Many people believed that disease was a punishment or test from God because of sin.

• The Theory of the Four Humours was very popular. It stated that an imbalance in the humours could cause illness.

• Other ideas about the causes of disease and illness included miasma (bad air) and a misalignment in the planets or stars.

Summary

Strengthen

S1 Create a spider diagram or a bullet point list to show the di� erent ideas people had between 1250 and 1500 about what caused illness and disease.

S2 List the four humours and their properties.

S3 Describe, in detail, the role of Hippocrates and Galen in medieval medicine.

Challenge

C1 Explain both why and how the Church had an impact on medieval medicine.

If you are not confi dent about this question, form a group with other students, discuss the answer and then record your conclusion. Your teacher can give you some hints.

Checkpoint

DraftDraftDraft

Many people believed that disease was a punishment or test from God because of sin.

Draft Many people believed that disease was a punishment or test from God because of sin.

Draft The Theory of the Four Humours was very popular. It stated that an imbalance in the humours could cause Draft The Theory of the Four Humours was very popular. It stated that an imbalance in the humours could cause Draft


20


Urine charts Although medieval physicians didn’t blame people’s urine for making them ill, they did carefully examine the urine in order to make their diagnosis. It was thought to be one of the best ways to check on the balance of the humours inside the body. Samples of a patient’s urine could be sent to a physician, where it would be examined and compared with a urine chart.

The physician would carefully check the colour, thickness, smell and even taste of the urine before making his diagnosis. This was seen as a very important part of medieval medicine: Norwich Cathedral Priory, for example, employed a full-time physician to examine urine.

Infl uences on ideas about the cause of disease

Figure 1.2 Three main factors to understanding change and continuity in early diagnosis of disease.

More on miasma It is worth noting that medieval physicians didn’t use the word ‘miasma’ to describe disease-spreading air, as far as we can tell from the evidence we have. Instead, they referred to it as ‘corruption of the air’, ‘pestilential air’ or ‘putrefaction of the air’. ‘Miasma’ was not used regularly until later.


Influencing beliefs:

the cause of diseases

Individuals and institutions,

including the Church and government

Science and technology

Attitudes in society

Hippocrates and Galen were important individuals in the Middle Ages, even though they lived many years before this time. Their books had been preserved by Arabic scholars and Latin translations were available in Europe by this time. Galen in particular was popular with the Church, which meant that his work was widely promoted.

Science and technology During the Middle Ages, a lack of scientifi c understanding meant that new knowledge was limited. Physicians and medical students tried to make new discoveries fi t into the old theories, rather than experimenting to explain the discoveries.

One important piece of technology invented near the end of the Middle Ages was the printing press. It was invented in around 1440 by Johannes Gutenberg in what is now Germany. Although this was not directly related to advancing medieval medicine, it eventually led to much faster and easier sharing of medical texts. However, it did not have a huge impact during this time period.

The Middle Ages was a time when there was continuity in ideas about the cause of disease. There were only a few small changes. For example, the use of astrology became more widespread, which meant it was adopted by many people, but did not expand upon Galen’s original theories. On the whole, ideas remained the same.

Individuals and the Church The Church was very important in maintaining the status quo at this time. This means that they did not like change, and wanted to keep things the way they were. The Church controlled medical learning. It chose which books were copied and distributed. The Church liked the Theory of the Four Humours because it fi tted with their teachings, so it promoted this theory. The Church strongly discouraged anybody from criticising the theory they supported.

Draftthickness, smell and even taste of the urine before

Draftthickness, smell and even taste of the urine before making his diagnosis. This was seen as a very important

Draftmaking his diagnosis. This was seen as a very important part of medieval medicine: Norwich Cathedral Priory,

Draftpart of medieval medicine: Norwich Cathedral Priory, for example, employed a full-time physician to examine Draftfor example, employed a full-time physician to examine

Figure 1.2

DraftFigure 1.2continuity in early diagnosis of disease.

Draftcontinuity in early diagnosis of disease.

DraftDraftDraft

Hippocrates and Galen were important individuals in

Draft Hippocrates and Galen were important individuals in


16

21


Attitudes in society Medieval people had a strong belief in God and did not want to risk going to hell by being critical of the Church. Physicians who did not follow the old ideas found it hard to get work, because everybody knew a ‘good’ physician would follow the Theory of the Four Humours. A famous 13 th -century military surgeon, Henri de Mondeville, was among those who questioned the old ways of practising medicine. Mondeville is even quoted as stating that classical fi gures like Hippocrates and Galen were like an old dog that needed to be put down, but whose owner could not face replacing it with a younger, healthier dog. However, even he continued to practise medicine in the same way as everybody else – he probably wouldn’t have found employment otherwise.

Many people believed that, since medicine had always been done this way, there was no need to change it now.

This activity will help you to decide the importance of each key idea about the cause of illness in the years c1250–c1500.

a On slips of paper, write down the key ideas about the causes of illness at this time: God; imbalanced humours; miasma; alignment of the planets/stars.

b Now put these into a hierarchy. Which do you think was the most important? Which was the least important? Do we still believe any of them today? Were some of these ideas more important to particular groups of people, or at di� erent times?

c Look back over the information in this section if you need to jog your memory. Discuss your ideas with another person or in a small group.

Activity

• Many people believed that disease was a punishment or test from God because of sin.

• The Theory of the Four Humours was very popular. It stated that an imbalance in the humours could cause illness.

• Other ideas about the causes of disease and illness included miasma (bad air) and a misalignment in the planets or stars.

Summary

Strengthen

S1 Create a spider diagram or a bullet point list to show the di� erent ideas people had between 1250 and 1500 about what caused illness and disease.

S2 List the four humours and their properties.

S3 Describe, in detail, the role of Hippocrates and Galen in medieval medicine.

Challenge

C1 Explain both why and how the Church had an impact on medieval medicine.

If you are not confi dent about this question, form a group with other students, discuss the answer and then record your conclusion. Your teacher can give you some hints.

Checkpoint

DraftDraftDraft

Many people believed that disease was a punishment or test from God because of sin.

Draft Many people believed that disease was a punishment or test from God because of sin.

Draft The Theory of the Four Humours was very popular. It stated that an imbalance in the humours could cause Draft The Theory of the Four Humours was very popular. It stated that an imbalance in the humours could cause Draft


17

23

1.2 Approaches to prevention and treatment

If prayers and o� erings did not work, there were other supernatural remedies available, although the Church did not approve of them. Chanting incantations and using charms or amulets to heal symptoms and ward o� diseases were fairly common throughout this period.

Sometimes the sick were discouraged from seeking cures. A� er all, if God had sent the disease to purge the soul, it was important for the disease to run its course. Looking for medicine to cure the disease might keep you alive, but it would mean that your soul would still be stained with sin. That meant risking not being admitted into heaven when you died.

Astrology Physicians consulted star charts when diagnosing illness. These were also important when prescribing treatment. Treatments varied according to the horoscope of the patient. The alignment of the planets was then checked at every stage of the treatment prescribed: herb gathering, bleeding, purging, operations and even cutting hair and nails all had to be done at the right time.

Humoural treatments Today, when we fall ill, doctors assess the symptoms, make a diagnosis and treat the infection. For example, if a patient catches mumps, the treatment prescribed will be to attack the germ, rather than make the swelling go down. This is because modern medicine recognises that treating the cause of the illness will eventually treat the symptom.

Medieval physicians did not work in the same way. Each symptom was broken down and treated separately, as they believed each symptom represented an imbalance in the humours. Therefore, confl icting remedies might be provided.

As well as making the locals a lot of money, the ability to heal the sick was also important to the local churchmen. In order to be declared a saint, the dead person had to be associated with a certain number of miracles; so, the more people who were ‘healed’ a� er touching the relics, the better.

The king’s healing power It was widely believed that the king had the power to heal certain illnesses. During the coronation of a monarch, his hands would be rubbed with special holy oil and this, it was said, gave him supernatural healing powers. The king’s touch was considered particularly e� ective for scrofula, a form of tuberculosis. Kings took this very seriously, as it was a good way to demonstrate their divine right (the idea that God had chosen them to be king). Edward I, for example, aimed to touch up to 2,000 people a year during his reign (1272–1307).


Advice from John of Gaddesden’s medical book, the Rosa Anglica . John, a very well-respected English physician, wrote this very popular medical text in the 14th century. Here, he explains how to cure lethargy [extreme tiredness].

It is necessary for lethargics that people talk loudly in their presence. Tie their extremities lightly and rub their palms and soles hard; and let their feet be put in salt water up to the middle of their shins, and pull their hair and nose, and squeeze the toes and � ngers tightly, and cause pigs to squeal in their ears; give them a sharp clyster [an enema] at the beginning…and open the vein of the head, or nose, or forehead, and draw blood from the nose with the bristles of a boar. Put a feather, or a straw, in his nose to compel him to sneeze, and do not ever desist from hindering him from sleeping; and let human hair or other evil-smelling thing be burnt under his nose…

Source A

Blood-letting Phlebotomy , or blood-letting/bleeding, was the most common treatment for an imbalance in the humours. The idea behind it was that bad humours could be literally removed from the body by removing some of the blood.

Phlebotomy was so common that most physicians didn’t even bother to carry out the procedure themselves – and monks were forbidden from bleeding their patients.

Draft If prayers and o� erings did not work, there were other

Draft If prayers and o� erings did not work, there were other supernatural remedies available, although the Church Draftsupernatural remedies available, although the Church did not approve of them. Chanting incantations and Draftdid not approve of them. Chanting incantations and using charms or amulets to heal symptoms and ward o� Draftusing charms or amulets to heal symptoms and ward o� Draftexample, aimed to touch up to 2,000 people a year

Draftexample, aimed to touch up to 2,000 people a year

DraftAnglica

DraftAnglica this very popular medical text in the 14th century. Here, he

Draftthis very popular medical text in the 14th century. Here, he explains how to cure lethargy [extreme tiredness].

Draftexplains how to cure lethargy [extreme tiredness].

It is necessary for lethargics that people talk loudly in

Draft It is necessary for lethargics that people talk loudly in


22


Religious and supernatural actions As the Church taught that disease was sent by God as a punishment for sin, it followed that the cure should also involve the supernatural. As well as looking for medical treatment for disease, it was important to undergo a course of spiritual healing. Religious treatments included:

• healing prayers and incantations (spells)

• paying for a special mass* to be said

• fasting (going without food).

Pilgrimages* to the tombs of people noted for their healing powers also became extremely popular. Once the pilgrimage was complete, there were a few suggested actions those with diseases could take (see Figure 1.3).

• Understand di� erent approaches to prevention and treatment before 1500.

• Understand how people cared for the sick, including treatments in hospitals and in the home before 1500.

Learning outcomes

Touching holy relics, suchas a piece of the ‘true’ crosson which Jesus was cruci�ed,or the bones of a saint.

Presenting an o�ering at ashrine - usually an image ofthe body part to be healed,

made from anything from waxto precious metals and jewels,

depending on how wealthyyou were.

Lighting a candle proportionatelyas tall as you (or as long as thebody part you wanted to heal).

Praying for God to helpheal your ailment.

Figure 1.3 Pilgrims su� ering from disease visit a holy site.

Mass*

Roman Catholic service where bread and wine is given. Catholics believe that this involves a miracle: the bread and wine is turned into the body and blood of Christ.

Pilgrimage*

A journey to an important religious monument, shrine or place.

Key terms

DraftDraftDraftDraft

Presenting an o�ering at a

DraftPresenting an o�ering at ashrine - usually an image of

Draftshrine - usually an image ofthe body part to be healed,Draftthe body part to be healed,

made from anything from waxDraftmade from anything from waxto precious metals and jewels,Draftto precious metals and jewels,Draft

A journey to an important religious monument,

Draft A journey to an important religious monument, shrine or place.

Draftshrine or place.

Draft


18

23


If prayers and o� erings did not work, there were other supernatural remedies available, although the Church did not approve of them. Chanting incantations and using charms or amulets to heal symptoms and ward o� diseases were fairly common throughout this period.

Sometimes the sick were discouraged from seeking cures. A� er all, if God had sent the disease to purge the soul, it was important for the disease to run its course. Looking for medicine to cure the disease might keep you alive, but it would mean that your soul would still be stained with sin. That meant risking not being admitted into heaven when you died.

Astrology Physicians consulted star charts when diagnosing illness. These were also important when prescribing treatment. Treatments varied according to the horoscope of the patient. The alignment of the planets was then checked at every stage of the treatment prescribed: herb gathering, bleeding, purging, operations and even cutting hair and nails all had to be done at the right time.

Humoural treatments Today, when we fall ill, doctors assess the symptoms, make a diagnosis and treat the infection. For example, if a patient catches mumps, the treatment prescribed will be to attack the germ, rather than make the swelling go down. This is because modern medicine recognises that treating the cause of the illness will eventually treat the symptom.

Medieval physicians did not work in the same way. Each symptom was broken down and treated separately, as they believed each symptom represented an imbalance in the humours. Therefore, confl icting remedies might be provided.

As well as making the locals a lot of money, the ability to heal the sick was also important to the local churchmen. In order to be declared a saint, the dead person had to be associated with a certain number of miracles; so, the more people who were ‘healed’ a� er touching the relics, the better.

The king’s healing power It was widely believed that the king had the power to heal certain illnesses. During the coronation of a monarch, his hands would be rubbed with special holy oil and this, it was said, gave him supernatural healing powers. The king’s touch was considered particularly e� ective for scrofula, a form of tuberculosis. Kings took this very seriously, as it was a good way to demonstrate their divine right (the idea that God had chosen them to be king). Edward I, for example, aimed to touch up to 2,000 people a year during his reign (1272–1307).


Advice from John of Gaddesden’s medical book, the Rosa Anglica . John, a very well-respected English physician, wrote this very popular medical text in the 14th century. Here, he explains how to cure lethargy [extreme tiredness].

It is necessary for lethargics that people talk loudly in their presence. Tie their extremities lightly and rub their palms and soles hard; and let their feet be put in salt water up to the middle of their shins, and pull their hair and nose, and squeeze the toes and � ngers tightly, and cause pigs to squeal in their ears; give them a sharp clyster [an enema] at the beginning…and open the vein of the head, or nose, or forehead, and draw blood from the nose with the bristles of a boar. Put a feather, or a straw, in his nose to compel him to sneeze, and do not ever desist from hindering him from sleeping; and let human hair or other evil-smelling thing be burnt under his nose…

Source A

Blood-letting Phlebotomy , or blood-letting/bleeding, was the most common treatment for an imbalance in the humours. The idea behind it was that bad humours could be literally removed from the body by removing some of the blood.

Phlebotomy was so common that most physicians didn’t even bother to carry out the procedure themselves – and monks were forbidden from bleeding their patients.

Draft If prayers and o� erings did not work, there were other

Draft If prayers and o� erings did not work, there were other supernatural remedies available, although the Church Draftsupernatural remedies available, although the Church did not approve of them. Chanting incantations and Draftdid not approve of them. Chanting incantations and using charms or amulets to heal symptoms and ward o� Draftusing charms or amulets to heal symptoms and ward o� Draftexample, aimed to touch up to 2,000 people a year

Draftexample, aimed to touch up to 2,000 people a year

DraftAnglica

DraftAnglica this very popular medical text in the 14th century. Here, he

Draftthis very popular medical text in the 14th century. Here, he explains how to cure lethargy [extreme tiredness].

Draftexplains how to cure lethargy [extreme tiredness].

It is necessary for lethargics that people talk loudly in

Draft It is necessary for lethargics that people talk loudly in


19

25


Laxatives were very common. Some well-known examples included mallow leaves stewed in ale, and linseeds fried in hot fat. Linseeds are still used today as a digestive aid.

Sometimes people needed a bit more help to purge, and the physician would administer a clyster or enema. For example, John of Arderne, a famous English surgeon, mixed water with honey, oil, wheat bran, soap and herbs such as mallow and camomile. He would squirt it into the patient’s anus using a greased pipe fi xed to a pig’s bladder, while the patient rubbed his stomach. This would clear out any stubborn blockages.

Remedies Sick people in the period c1250–c1500 were also treated with remedies – usually herbal infusions to drink, sni� or bathe in.

Some of these are still in use today. For example, aloe vera was prescribed to improve digestion. Other ingredients featured regularly included mint, camomile and rose oils, tamarind, almonds, sa� ron, butter, absinth, turpentine and corals. Sometimes the ingredients were expensive and di� cult to fi nd.

A common remedy mixed and sold at this time was theriaca . This was a spice-based mixture that could contain up to 70 ingredients, including quite common things like ginger, cardamom, pepper and sa� ron, but also some unusual ingredients like viper fl esh and opium. Galen had written a book on theriacas, looking particularly at their use in treating snake bites and poisons. Over time, they became widely popular and were used for many di� erent illnesses.

Di� erent foods were prescribed to encourage the balance of the humours – remember that the humours were thought to be created from the digestion of food. A dish called blanc mangier , made from chicken and almonds, was regularly recommended for medieval invalids because the ingredients were warm and moist.

Bathing Warm baths were regularly prescribed to help the body draw in heat to help dissolve blockages in the humours. This gave the body the opportunity to steam out impurities and ease aching joints. Herbal remedies could also be given this way.

Popular books There were many books around at this time that gathered together knowledge of the healing powers of herbs and plants. These were generally known as Materia Medica . The most popular book had been written by a Roman called Dioscorides in the 1st century CE. He had catalogued around 600 plants, roots, trees, minerals, essences and balms and their properties.

Another popular herbal manual was the Circa Instans . Published in the 12th century, it included details of the use of minerals and metals. It also gave recommendations on how to use the ingredients in spells and incantations.


Remedies

Herbal (e.g. aloe vera,

mint, camomile)

Bathing

Superstitions

Food, to balance

humours

Various plants and herbs were added to the bath water to help. For example, people su� ering from bladder stones were advised to stir in mallow and violets.

Some of the remedies were less pleasant and were based purely on superstition: those su� ering from paralysis were advised to boil a fox in water and then bathe in it! This was because it was thought that the quick and nimble properties of the fox would be transferred to the patient through the bath water.

Figure 1.3 Common remedies, c1250–c1500.

Draftaloe vera was prescribed to improve digestion.

Draftaloe vera was prescribed to improve digestion. Other ingredients featured regularly included mint,

DraftOther ingredients featured regularly included mint, camomile and rose oils, tamarind, almonds, sa� ron,

Draftcamomile and rose oils, tamarind, almonds, sa� ron, butter, absinth, turpentine and corals. Sometimes the Draftbutter, absinth, turpentine and corals. Sometimes the ingredients were expensive and di� cult to fi nd. Draftingredients were expensive and di� cult to fi nd.

A common remedy mixed and sold at this time was Draft A common remedy mixed and sold at this time was Draft

DraftSuperstitions

DraftSuperstitions


24


Instead, it was done by barber surgeons, wise women or even those with no medical background, like the parish constable.

Bleeding was carried out in several di� erent ways.

Type Method Uses

Cutting a vein

This involved cutting open a vein with a lancet or other sharp instrument. Blood was usually let from a vein near the elbow, because it was easy to access.

The most straightforward method of bleeding. Phlebotomy charts like the vein man (see Source B) were used to show points in the body where bleeding was recommended for specifi c illnesses.

Leeches Freshwater leeches were collected, washed and kept hungry for a day before being placed on the skin. Bleeding might continue for up to 10 hours a� er the leech was full.

Used for people whose age or condition made traditional bleeding too dangerous.

Cupping The skin was pierced with a knife or a pin, or even scratched with fi ngernails, until it was bleeding. A heated cup was placed over the cuts to create a vacuum. This drew blood out of the skin.

Used for women, children and the very old. People believed di� erent areas treated di� erent illnesses. For example, people believed that cupping on the back of the neck was good for eye trouble, bad breath and facial acne.

Sometimes patients were bled for too long and died as a result. Evidence suggests that this was quite common and it was probably seen as a necessary hazard. In 1278, court records from an inquest in London show that William le Paumer had collapsed and died thanks to a blood-letting procedure that had taken place the previous day. The court did not hold anybody responsible for the death, and didn’t even name the person who had carried out the bleeding.

A vein man, or phlebotomy chart. This picture was printed in a manual belonging to the York Barbers in the late 15th century. It shows points on the body where bloodletting should happen, matching di� erent ailments with di� erent places on the body. For example, if a patient was su� ering from depression, the recommendation was to bleed them from a vein in the back.

Source B

Purging Because it was believed that the humours were created from the foods eaten, a common treatment was purging the digestive system to remove any le� over food. This was done by giving the patient either something to make them vomit (an emetic), or a laxative or enema to clear out anything le� over in the body.

Emetics usually consisted of strong and bitter herbs like scammony, aniseed and parsley. Sometimes they contained poisons like black hellebore, so it was best to vomit them up quickly.

DraftDraftDrafttraditional bleeding

Drafttraditional bleeding too dangerous.

Drafttoo dangerous.

Draft


20

25


Laxatives were very common. Some well-known examples included mallow leaves stewed in ale, and linseeds fried in hot fat. Linseeds are still used today as a digestive aid.

Sometimes people needed a bit more help to purge, and the physician would administer a clyster or enema. For example, John of Arderne, a famous English surgeon, mixed water with honey, oil, wheat bran, soap and herbs such as mallow and camomile. He would squirt it into the patient’s anus using a greased pipe fi xed to a pig’s bladder, while the patient rubbed his stomach. This would clear out any stubborn blockages.

Remedies Sick people in the period c1250–c1500 were also treated with remedies – usually herbal infusions to drink, sni� or bathe in.

Some of these are still in use today. For example, aloe vera was prescribed to improve digestion. Other ingredients featured regularly included mint, camomile and rose oils, tamarind, almonds, sa� ron, butter, absinth, turpentine and corals. Sometimes the ingredients were expensive and di� cult to fi nd.

A common remedy mixed and sold at this time was theriaca . This was a spice-based mixture that could contain up to 70 ingredients, including quite common things like ginger, cardamom, pepper and sa� ron, but also some unusual ingredients like viper fl esh and opium. Galen had written a book on theriacas, looking particularly at their use in treating snake bites and poisons. Over time, they became widely popular and were used for many di� erent illnesses.

Di� erent foods were prescribed to encourage the balance of the humours – remember that the humours were thought to be created from the digestion of food. A dish called blanc mangier , made from chicken and almonds, was regularly recommended for medieval invalids because the ingredients were warm and moist.

Bathing Warm baths were regularly prescribed to help the body draw in heat to help dissolve blockages in the humours. This gave the body the opportunity to steam out impurities and ease aching joints. Herbal remedies could also be given this way.

Popular books There were many books around at this time that gathered together knowledge of the healing powers of herbs and plants. These were generally known as Materia Medica . The most popular book had been written by a Roman called Dioscorides in the 1st century CE. He had catalogued around 600 plants, roots, trees, minerals, essences and balms and their properties.

Another popular herbal manual was the Circa Instans . Published in the 12th century, it included details of the use of minerals and metals. It also gave recommendations on how to use the ingredients in spells and incantations.


Remedies

Herbal (e.g. aloe vera,

mint, camomile)

Bathing

Superstitions

Food, to balance

humours

Various plants and herbs were added to the bath water to help. For example, people su� ering from bladder stones were advised to stir in mallow and violets.

Some of the remedies were less pleasant and were based purely on superstition: those su� ering from paralysis were advised to boil a fox in water and then bathe in it! This was because it was thought that the quick and nimble properties of the fox would be transferred to the patient through the bath water.

Figure 1.3 Common remedies, c1250–c1500.

Draftaloe vera was prescribed to improve digestion.

Draftaloe vera was prescribed to improve digestion. Other ingredients featured regularly included mint,

DraftOther ingredients featured regularly included mint, camomile and rose oils, tamarind, almonds, sa� ron,

Draftcamomile and rose oils, tamarind, almonds, sa� ron, butter, absinth, turpentine and corals. Sometimes the Draftbutter, absinth, turpentine and corals. Sometimes the ingredients were expensive and di� cult to fi nd. Draftingredients were expensive and di� cult to fi nd.

A common remedy mixed and sold at this time was Draft A common remedy mixed and sold at this time was Draft

DraftSuperstitions

DraftSuperstitions


21

27


Fear of digestive problems leading to death was so great that many people purged themselves, either by vomiting or using laxatives, as a way of preventing disease as well as treating it. Hippocrates recommended using an emetic once a fortnight in the winter, and to use enemas in the summer.

Purifying the air Medieval people attempted to keep the air free from miasmata by purifying it. They did this by spreading sweet herbs, such as lavender. Sometimes this might be carried as a posy, or placed inside a decorative piece of jewellery called a pomander (a large locket, which would be worn around the waist).

Local authorities, usually under the direction of magistrates or noblemen, also tried to tackle miasmata outside of the home, putting into place measures to keep towns clean. For example, they tried to make sure there were no rotting animals le� lying around and pulled down or cleaned particularly smelly public toilets.

Medieval ‘medics’ Most people in the Middle Ages would have been treated at home by a female family member. Women did most of the treatment at home, caring for the sick and mixing remedies themselves. Women also acted as midwives: evidence from medieval sources suggests that only women attended births.

Asking for medical advice cost a lot of money. Since the treatments weren’t guaranteed, most people were not willing to spend this money even if they had it. However, there were other treatment options for people willing to pay.

Physicians During the Middle Ages, new universities were set up across Europe, including Oxford, Cambridge, Paris, Bologna, Montpellier and Padua. Medicine became more professional. A medical degree took between seven and ten years to complete, depending on the level and university.

Medieval doctors were known as physicians – the word ‘doctor’ did not become common until the 17th century.

The main role of a physician was to diagnose illness and recommend a course of treatment. They rarely got involved in treating the patients themselves – this was le� up to less educated midwives, apothecaries or barber surgeons.

If you were lucky enough to be able to a� ord a physician, he might attend in person to examine you, but this wasn’t really considered necessary. The consultation would follow three stages.

1 The physician would look at a sample of the patient’s urine, faeces and blood, all of which would be collected and sent to him.

2 He would also consult the astrological charts under which the patient was born and at the time they fell sick.

3 Based on this, and the humoural tendencies of the patient (whether they were naturally sanguine, choleric, phlegmatic or melancholic), the physician would create a course of treatment.

It was then up to less trained and lower paid professionals to carry out the treatment. For most of this period, this was due to the fact that many physicians were clergymen, who were forbidden from carrying out procedures such as bleeding. From 1215 onwards, any operations likely to involve cutting the patient were also forbidden.

During this time, new universities and centres for medical learning were set up in Europe without religious sponsorship. Foreign physicians who had no connection to the Church were able to both diagnose and treat their patients.

Physicians were also very expensive, because there weren’t many of them. This was mainly due to the training taking a long time. Royalty and the very wealthy o� en employed a physician full time. Others paid for them when they needed them.

Apothecaries Apothecaries mainly mixed herbal remedies. They had a good knowledge of the healing power of herbs and plants thanks to studying herbal manuals such as Materia Medica . They usually had a good amount of knowledge from their own experience, or passed down from family members.

Draftkeep towns clean. For example, they tried to make sure

Draftkeep towns clean. For example, they tried to make sure there were no rotting animals le� lying around and

Draftthere were no rotting animals le� lying around and pulled down or cleaned particularly smelly public toilets.

Draftpulled down or cleaned particularly smelly public toilets.

Most people in the Middle Ages would have been Draft Most people in the Middle Ages would have been treated at home by a female family member. Women Drafttreated at home by a female family member. Women

choleric, phlegmatic or melancholic), the physician

Draftcholeric, phlegmatic or melancholic), the physician would create a course of treatment.

Draftwould create a course of treatment.

It was then up to less trained and lower paid

Draft It was then up to less trained and lower paid


26


Preventing disease Although a physician could expect to be paid a lot more money for providing treatments for disease, there was a strong focus on following various regimes to prevent getting sick in the fi rst place. This was a far safer plan of action, since cures and treatments were hit-and-miss in their e� ectiveness.

The Church Most people believed that the best, and most important, way of preventing disease was to lead a life free from sin. Regular prayers, confessions and o� ering tithes to the Church worked together to ensure that any minor sins were quickly forgiven.

Hygiene Once your spiritual health was taken care of, it was important to concentrate on your bodily health, too. Guidance on doing this was contained in a set of instructions known as the regimen sanitatis.

Regimen Sanitatis The Regimen Sanitatis was a loose set of instructions provided by physicians to help a patient maintain good health. It fi rst appeared in the work of Hippocrates, where it was later picked up by Galen and Arabic scholars like Avicenna. This meant that the advice was widespread and very common by 1250. A lot of the advice is familiar to us today.

Ideally, a physician would provide a regimen sanitatis written especially for their patient, taking into account their predominant humours and lifestyle. However, in practice, this service was only used by the very rich, because it took a long time to write such a detailed set of instructions for every patient.

Bathing was an important treatment for disease. It was also used as a preventative measure: bad smells indicated a miasma. However, only the wealthy could a� ord a private bath of hot water. Public baths, or stewes , were available for a fee. Poorer people swam in rivers, where possible, to keep themselves fresh. Although only the wealthy bathed their whole bodies regularly, everybody – no matter how poor – washed their hands before and usually a� er every meal. They believed that cleanliness was next to godliness, so it was important to stay clean.

Figure 1.4 Advice given in the Regimen Sanitatis.

As well as keeping themselves clean, people also tried to make sure their homes smelled sweet and fresh, too. Floors were swept regularly and rushes were laid down to soak up any mess. Sometimes sweet smelling herbs, like lavender, were spread with the rushes to keep the air free of miasmata.

Diet Since the humours were thought to be produced by digestion, what and when you ate were both considered very important in preventing an imbalance. Eating too much was strongly discouraged.

According to the chroniclers of the time, several medieval kings died as a result of eating too much, or having too rich a diet. Edward I and Henry V both died of dysentery*, for example.

Dysentery*

Very severe diarrhoea.

Key term

Draft The Regimen Sanitatis was a loose set of instructions Draft The Regimen Sanitatis was a loose set of instructions provided by physicians to help a patient maintain good Draftprovided by physicians to help a patient maintain good Draft


22

27


Fear of digestive problems leading to death was so great that many people purged themselves, either by vomiting or using laxatives, as a way of preventing disease as well as treating it. Hippocrates recommended using an emetic once a fortnight in the winter, and to use enemas in the summer.

Purifying the air Medieval people attempted to keep the air free from miasmata by purifying it. They did this by spreading sweet herbs, such as lavender. Sometimes this might be carried as a posy, or placed inside a decorative piece of jewellery called a pomander (a large locket, which would be worn around the waist).

Local authorities, usually under the direction of magistrates or noblemen, also tried to tackle miasmata outside of the home, putting into place measures to keep towns clean. For example, they tried to make sure there were no rotting animals le� lying around and pulled down or cleaned particularly smelly public toilets.

Medieval ‘medics’ Most people in the Middle Ages would have been treated at home by a female family member. Women did most of the treatment at home, caring for the sick and mixing remedies themselves. Women also acted as midwives: evidence from medieval sources suggests that only women attended births.

Asking for medical advice cost a lot of money. Since the treatments weren’t guaranteed, most people were not willing to spend this money even if they had it. However, there were other treatment options for people willing to pay.

Physicians During the Middle Ages, new universities were set up across Europe, including Oxford, Cambridge, Paris, Bologna, Montpellier and Padua. Medicine became more professional. A medical degree took between seven and ten years to complete, depending on the level and university.

Medieval doctors were known as physicians – the word ‘doctor’ did not become common until the 17th century.

The main role of a physician was to diagnose illness and recommend a course of treatment. They rarely got involved in treating the patients themselves – this was le� up to less educated midwives, apothecaries or barber surgeons.

If you were lucky enough to be able to a� ord a physician, he might attend in person to examine you, but this wasn’t really considered necessary. The consultation would follow three stages.

1 The physician would look at a sample of the patient’s urine, faeces and blood, all of which would be collected and sent to him.

2 He would also consult the astrological charts under which the patient was born and at the time they fell sick.

3 Based on this, and the humoural tendencies of the patient (whether they were naturally sanguine, choleric, phlegmatic or melancholic), the physician would create a course of treatment.

It was then up to less trained and lower paid professionals to carry out the treatment. For most of this period, this was due to the fact that many physicians were clergymen, who were forbidden from carrying out procedures such as bleeding. From 1215 onwards, any operations likely to involve cutting the patient were also forbidden.

During this time, new universities and centres for medical learning were set up in Europe without religious sponsorship. Foreign physicians who had no connection to the Church were able to both diagnose and treat their patients.

Physicians were also very expensive, because there weren’t many of them. This was mainly due to the training taking a long time. Royalty and the very wealthy o� en employed a physician full time. Others paid for them when they needed them.

Apothecaries Apothecaries mainly mixed herbal remedies. They had a good knowledge of the healing power of herbs and plants thanks to studying herbal manuals such as Materia Medica . They usually had a good amount of knowledge from their own experience, or passed down from family members.

Draftkeep towns clean. For example, they tried to make sure

Draftkeep towns clean. For example, they tried to make sure there were no rotting animals le� lying around and

Draftthere were no rotting animals le� lying around and pulled down or cleaned particularly smelly public toilets.

Draftpulled down or cleaned particularly smelly public toilets.

Most people in the Middle Ages would have been Draft Most people in the Middle Ages would have been treated at home by a female family member. Women Drafttreated at home by a female family member. Women

choleric, phlegmatic or melancholic), the physician

Draftcholeric, phlegmatic or melancholic), the physician would create a course of treatment.

Draftwould create a course of treatment.

It was then up to less trained and lower paid

Draft It was then up to less trained and lower paid


23

29


Caring for the sick: hospitals and the home Hospitals The number of hospitals in England was on the rise during the Middle Ages. By 1500, there were an estimated 1,100 hospitals, ranging in size from just a few beds to hundreds. Bury St Edmund’s, for example, had at least six hospitals to cater for lepers, the infi rm and the old. The city had a shrine famous for its healing powers and therefore attracted a lot of sick people. However, many hospitals did not treat the sick. Instead, they o� ered hospitality to travellers and pilgrims, which is how hospitals got their name.

About 30% of the hospitals in England were owned and run by the Church in the Middle Ages. These were run by the monks and nuns who lived in nearby monasteries.

Medieval hospitals were good places to rest and recover. The space would have been kept very clean and the bed linens and clothing of the patients changed regularly. It was a large part of the nuns’ duties to do the washing and make sure everywhere was kept clean. This meant that, for people not su� ering from terminal disease, hospitals were probably quite successful.

Insane and pregnant patients were o�en rejected, though some hospitals had special beds reserved for unmarried mothers.

Patients would share beds.

Usually sta�ed by monks and nuns. The nuns would do the routine nursing, while the priests and monks saw to the spiritual welfare of the patients.

Focus was placed on caring for the sick, rather than curing disease. The Church believed that diseases had been sent by God as a punishment for sin, so only prayers could cure it.

Figure 1.5 Common features of medieval hospitals.

The rest were funded by an endowment , where a wealthy person had le� money in their will for the setting up of a hospital. Since charity was a foundation of religion and the Church taught that charitable donations could help to heal disease, it is not surprising that there were so many. The Church was in charge of running many of these hospitals, too.

Medieval hospitals that did treat the sick were not the same as the hospitals we have today.

DraftDraft


28


Apothecaries were not considered as skilled or knowledgeable as physicians. Physicians prescribed the medication and apothecaries were just there to mix the remedy. However, since doctors were expensive and apothecaries were comparatively cheap, lots of people would see an apothecary as an alternative to a doctor. This meant that doctors saw them as a threat to their livelihood.

Finally, many apothecaries also dabbled in alchemy and the supernatural, providing amulets and charms for patients who wanted something extra to cure a disease. This was frowned upon by the Church and, since many physicians were also priests, this meant that the gap between physicians and apothecaries became even wider.

Surgeons Barber surgeons were probably the least qualifi ed medical professionals in England. Since good barbers had sharp knives and a steady hand, they regularly performed small surgeries as well, such as pulling teeth and bleeding patients.

A picture of an apothecary’s shop taken from an Italian medical text published in the 14th century. The shelves are fi lled with large, ornate jars, which held theriac.

Source C

Apothecaries did not just create remedies, they also prescribed poison. This went against an idea fundamental to physicians – that they should do no harm. This rule went all the way back to Hippocrates and still exists today: all doctors must swear a Hippocratic Oath before practising medicine. Apothecaries were not bound by this rule, so they could not be trusted to do the best for their patient. Nor did they need to attend university to set up their business.

Barber surgeons Until 1307, barber surgeons advertised their services by putting a bowl of blood in their shop windows; a� er that, they displayed the sign of a bandaged, bloodied arm, which later became the red and white striped barber pole still used today.


Some surgeons were highly trained: in Europe, some physicians were encouraged to study surgery alongside medicine, so many had learned their skills at university. In fact, the quality of surgery was arguably higher than the quality of medical advice, because it was usually based on experience rather than knowledge learned from books. In medieval England, a skilled surgeon could set a broken limb, remove an arrow or even successfully remove cataracts from the eyes.

1 Draw a cartoon stick fi gure to represent each di� erent medical professional. Add labels to explain what sort of treatments each person carried out.

2 Explain how each of the di� erent types was trained to do their job.

3 Why do you think there was so much friction between the di� erent types of medics in medieval England?

Activities

DraftDraftDraft

Barber surgeons

Draft Barber surgeons Until 1307, barber surgeons advertised their services

Draft Until 1307, barber surgeons advertised their services by putting a bowl of blood in their shop windows;

Draftby putting a bowl of blood in their shop windows; a� er that, they displayed the sign of a bandaged,

Drafta� er that, they displayed the sign of a bandaged, bloodied arm, which later became the red and white

Draftbloodied arm, which later became the red and white striped barber pole still used today.

Draftstriped barber pole still used today.


24

29


Caring for the sick: hospitals and the home Hospitals The number of hospitals in England was on the rise during the Middle Ages. By 1500, there were an estimated 1,100 hospitals, ranging in size from just a few beds to hundreds. Bury St Edmund’s, for example, had at least six hospitals to cater for lepers, the infi rm and the old. The city had a shrine famous for its healing powers and therefore attracted a lot of sick people. However, many hospitals did not treat the sick. Instead, they o� ered hospitality to travellers and pilgrims, which is how hospitals got their name.

About 30% of the hospitals in England were owned and run by the Church in the Middle Ages. These were run by the monks and nuns who lived in nearby monasteries.

Medieval hospitals were good places to rest and recover. The space would have been kept very clean and the bed linens and clothing of the patients changed regularly. It was a large part of the nuns’ duties to do the washing and make sure everywhere was kept clean. This meant that, for people not su� ering from terminal disease, hospitals were probably quite successful.

Insane and pregnant patients were o�en rejected, though some hospitals had special beds reserved for unmarried mothers.

Patients would share beds.

Usually sta�ed by monks and nuns. The nuns would do the routine nursing, while the priests and monks saw to the spiritual welfare of the patients.

Focus was placed on caring for the sick, rather than curing disease. The Church believed that diseases had been sent by God as a punishment for sin, so only prayers could cure it.

Figure 1.5 Common features of medieval hospitals.

The rest were funded by an endowment , where a wealthy person had le� money in their will for the setting up of a hospital. Since charity was a foundation of religion and the Church taught that charitable donations could help to heal disease, it is not surprising that there were so many. The Church was in charge of running many of these hospitals, too.

Medieval hospitals that did treat the sick were not the same as the hospitals we have today.

DraftDraft


25

31


Women likely had many more healing skills than just mixing herbal remedies and keeping the patient clean, warm and well-fed. There is some suggestion that they carried out minor surgeries and bleedings – however, records are very patchy. This might be because it was taken for granted that women cared for the sick, so nobody bothered to record it when it happened.

An extract from a letter sent from Margaret Paston to her husband, John Paston, in 1464. The Pastons were wealthy landowners living in Norfolk; at the time that this letter was written, John Paston was staying in London.

For God’s sake beware of any medicine that you get from any physicians in London. I shall never trust them because of what happened to your father and my uncle, whose souls God forgive.

Source E

Strengthen

S1 What were the three di� erent types of blood-letting?

S2 List the di� erent ways people tried to prevent disease in medieval England.

S3 List the di� erent sources of help sick people had in medieval England.

Challenge

C1 You need to show links between the treatments and remedies used in the Middle Ages, and the ideas people had about what caused disease. With this in mind, create a revision resource, matching what you learned about the causes of disease with what you have learned about treatments. This could take the form of a table, a poster or a ‘pairs’ game to play when you are revising.

C2 Add to your revision resource about treatments, linking the di� erent sources of treatment to di� erent beliefs about disease.

C3 Identify which di� erent sources of treatment were available to di� erent groups of people (for example: the rich, the poor, pregnant women, lepers).

If you do not feel confi dent answering any of these questions, discuss them with a partner or in a group.

Checkpoint

• Supernatural treatments included prayer, fasting and pilgrimages.

• Other supernatural treatments included saying spells or carrying amulets, although these were discouraged by the Church.

• There were a large number of treatments aimed at rebalancing the humours. This was normally done by eating a particular food, taking herbal remedies or by purging the body to remove bad humours, either by making the patient vomit or go to the toilet.

• Because there were no guaranteed treatments, medieval people were advised to avoid getting ill by living a healthy lifestyle and keeping clean.

• Physicians, apothecaries and barber surgeons all provided di� erent treatments.

• Hospitals followed religious teachings. Patients were cared for and prayers were said, but they rarely received any medical treatment. However, most sick people were cared for in the home by a female family member.

Summary

Draft There were a large number of treatments aimed at rebalancing the humours. This was normally done by eating

Draft There were a large number of treatments aimed at rebalancing the humours. This was normally done by eating a particular food, taking herbal remedies or by purging the body to remove bad humours, either by making the

Drafta particular food, taking herbal remedies or by purging the body to remove bad humours, either by making the

Because there were no guaranteed treatments, medieval people were advised to avoid getting ill by living a

Draft Because there were no guaranteed treatments, medieval people were advised to avoid getting ill by living a healthy lifestyle and keeping clean.

Drafthealthy lifestyle and keeping clean.

Physicians, apothecaries and barber surgeons all provided di� erent treatments.

Draft Physicians, apothecaries and barber surgeons all provided di� erent treatments.

Hospitals followed religious teachings. Patients were cared for and prayers were said, but they rarely received Draft Hospitals followed religious teachings. Patients were cared for and prayers were said, but they rarely received Draftany medical treatment. However, most sick people were cared for in the home by a female family member. Draftany medical treatment. However, most sick people were cared for in the home by a female family member.


30


Naturally, this is what the Church wanted: a recovery was further proof of the existence of God and the importance of prayer.

The home Although many hospitals were established in medieval England, the vast majority of sick people were cared for at home. It was expected that women would care for their relatives and dependents when needed. This care would have involved making the patient comfortable, preparing restorative foods and mixing herbal remedies.

Women would also be responsible for the garden, in which they were expected to grow various plants known for their healing properties, such as marigolds and clover.

Some historical sources hint that women in the home were well-respected for their healing skills. Letters written in 1464 between Lady Margaret Paston and her husband Sir John, when he was sick in London and she was at home worrying about him, show that neither of them trusted doctors and both would have been happier if he had been at home receiving treatment from her.

A picture of a medieval hospital, 1482. Some of the patients are sharing beds, which was normal at this time. The only patient allowed their own bed was a dying woman. Henry VII’s famous hospital, the Savoy, opened in 1512. It was unique in o� ering all patients their own beds.

Source D

Many European hospitals employed physicians and surgeons, but there is no evidence to suggest that English hospitals did the same. Since religious men were forbidden from cutting into the body, treatment was very limited.

Infectious or terminal patients were o� en rejected from hospitals, as prayer and penance could do nothing for these people. However, patients who had a chance of recovery were able to see the altar and even participate in Church services from their beds, to help with the healing of their souls.

‘Hospital treatment in England in the period from 1250 to 1500 was very rare.’

How far do you agree? Explain your answer.


• charity hospitals

• care in the home.

You must also use some information of your own. 16 marks


This question gives four marks for good spelling, grammar and punctuation, and the use of specialist terms. Take extra care over things like capital letters for key words.

Exam tip

Drafthad been at home receiving treatment from her.

Drafthad been at home receiving treatment from her.

Draft ‘Hospital treatment in England in the period from

Draft ‘Hospital treatment in England in the period from

DraftDraft Exam-style question, Section B

Draft Exam-style question, Section B


26

31


Women likely had many more healing skills than just mixing herbal remedies and keeping the patient clean, warm and well-fed. There is some suggestion that they carried out minor surgeries and bleedings – however, records are very patchy. This might be because it was taken for granted that women cared for the sick, so nobody bothered to record it when it happened.

An extract from a letter sent from Margaret Paston to her husband, John Paston, in 1464. The Pastons were wealthy landowners living in Norfolk; at the time that this letter was written, John Paston was staying in London.

For God’s sake beware of any medicine that you get from any physicians in London. I shall never trust them because of what happened to your father and my uncle, whose souls God forgive.

Source E

Strengthen

S1 What were the three di� erent types of blood-letting?

S2 List the di� erent ways people tried to prevent disease in medieval England.

S3 List the di� erent sources of help sick people had in medieval England.

Challenge

C1 You need to show links between the treatments and remedies used in the Middle Ages, and the ideas people had about what caused disease. With this in mind, create a revision resource, matching what you learned about the causes of disease with what you have learned about treatments. This could take the form of a table, a poster or a ‘pairs’ game to play when you are revising.

C2 Add to your revision resource about treatments, linking the di� erent sources of treatment to di� erent beliefs about disease.

C3 Identify which di� erent sources of treatment were available to di� erent groups of people (for example: the rich, the poor, pregnant women, lepers).

If you do not feel confi dent answering any of these questions, discuss them with a partner or in a group.

Checkpoint

• Supernatural treatments included prayer, fasting and pilgrimages.

• Other supernatural treatments included saying spells or carrying amulets, although these were discouraged by the Church.

• There were a large number of treatments aimed at rebalancing the humours. This was normally done by eating a particular food, taking herbal remedies or by purging the body to remove bad humours, either by making the patient vomit or go to the toilet.

• Because there were no guaranteed treatments, medieval people were advised to avoid getting ill by living a healthy lifestyle and keeping clean.

• Physicians, apothecaries and barber surgeons all provided di� erent treatments.

• Hospitals followed religious teachings. Patients were cared for and prayers were said, but they rarely received any medical treatment. However, most sick people were cared for in the home by a female family member.

Summary

Draft There were a large number of treatments aimed at rebalancing the humours. This was normally done by eating

Draft There were a large number of treatments aimed at rebalancing the humours. This was normally done by eating a particular food, taking herbal remedies or by purging the body to remove bad humours, either by making the

Drafta particular food, taking herbal remedies or by purging the body to remove bad humours, either by making the

Because there were no guaranteed treatments, medieval people were advised to avoid getting ill by living a

Draft Because there were no guaranteed treatments, medieval people were advised to avoid getting ill by living a healthy lifestyle and keeping clean.

Drafthealthy lifestyle and keeping clean.

Physicians, apothecaries and barber surgeons all provided di� erent treatments.

Draft Physicians, apothecaries and barber surgeons all provided di� erent treatments.

Hospitals followed religious teachings. Patients were cared for and prayers were said, but they rarely received Draft Hospitals followed religious teachings. Patients were cared for and prayers were said, but they rarely received Draftany medical treatment. However, most sick people were cared for in the home by a female family member. Draftany medical treatment. However, most sick people were cared for in the home by a female family member.


27

33

1.3 Dealing with the Black Death, 1348–49

corruption to the body’s humours. People believed that this impure air may have originated from poisonous fumes released by an earthquake or a volcano.

Common beliefs For the everyday people living in the cities and countryside, the spread of the Black Death was terrifying and they would have heard many confl icting ideas about what caused it, including the ones above. In Europe, many people blamed the Jewish population, but the Jews had been expelled from England in the 13th century, so this was not the case in England.

Treatments of the Black Death Supernatural The main recommendation to treat the Black Death was to confess your sins, and ask God for forgiveness through prayer. However, there was an air of inevitability about the disease: once caught, people believed it was clearly God’s will; if it was his will that the patient should die, there was no cure that would work.

Natural To begin with, physicians tried bleeding and purging – the same things they would usually do to correct a humoural imbalance. Unfortunately, that didn’t work and, in fact, seemed to make people die more quickly.

As well as this, physicians recommended strong-smelling herbs like aloe and myrrh, which were believed to have cleansing properties. They o� en prescribed theriaca, as it was believed to work for lots of ailments. Lighting a fi re and boiling vinegar could also drive o� the bad air. Physicians or surgeons sometimes lanced the buboes – occasionally, people whose buboes burst survived.

Common beliefs Everyday people were willing to try anything to survive the Black Death. They held strong Christian beliefs, and so would have gone to confession and prayed, as well as seeking traditional cures like bleeding. However, it quickly became clear that neither priests nor physicians were capable of curing the disease.

Chest pains and breathing troubles

Boils and black buboesappearing in the groin

and armpits

Fever

Sneezing and coughingup blood

Symptoms ofBlack Death

Figure 1.6 Symptoms of the Black Death.

The Black Death is the name given by Victorian historians to the particular outbreak of the plague in 1348. A� er this, the plague returned every 10–20 years, although it killed fewer people with each subsequent outbreak.

People applied the same knowledge they had about the causes of disease and illness to the plague. New treatments appeared and advice on how to avoid catching the disease spread quickly.

Causes of the Black Death Religious and supernatural Many believed that the Black Death was the result of God deserting mankind – that is, the Black Death was a punishment for the sin in the world.

In 1345, there was an unusual positioning of the planets Mars, Jupiter and Saturn in the 14th degree of Aquarius, which astrologers interpreted as a sign that something wonderful or terrible was about to happen.

Natural causes The main natural cause attributed to the Black Death was the impure air. Breathing in this miasma caused

Draftwas to confess your sins, and ask God for forgiveness

Draftwas to confess your sins, and ask God for forgiveness through prayer. However, there was an air of inevitability

Draftthrough prayer. However, there was an air of inevitability about the disease: once caught, people believed it was

Draftabout the disease: once caught, people believed it was clearly God’s will; if it was his will that the patient should

Draftclearly God’s will; if it was his will that the patient should

The Black Death is the name given by Victorian historians Draft The Black Death is the name given by Victorian historians to the particular outbreak of the plague in 1348. A� er Draftto the particular outbreak of the plague in 1348. A� er this, the plague returned every 10–20 years, although it Draftthis, the plague returned every 10–20 years, although it


32


In 1348, a new disease reached the shores of England. It had spread from the Far East along trade routes, arriving in Sicily in 1347, quickly spreading across the whole of Europe. The Black Death , as it eventually came to be known, was a new plague that was unfamiliar to the ordinary people of England, as well as English physicians. Within months, it had spread the length and breadth of England, killing thousands of people. It was absolutely devastating: it didn’t matter if you were rich, poor, a city dweller or a country farmer – the plague did not discriminate. Those who caught it could expect to die within a matter of days.

The plague still occurs every so o� en in modern times, but it is easily treated with antibiotics and patients usually make a full recovery, as long as it is caught in time. In the Middle Ages, treatments like this did not exist. People were completely unprepared, and they did not know how prevent and treat the ‘scourge’*.

• Understand what the Black Death was and how it a� ected people in England during the years 1348-49.

• Understand the disputed causes, treatments and preventative measures used on those su� ering from the Black Death.

Learning outcomes

This engraving from the 14th century shows somebody su� ering from the Black Death.

Source A

Scourge*

A person or thing that causes great su� ering.

Key term

In this extract from a report on the Black Death written in 1347, Italian chronicler Marchione di Coppo Stefani describes how helpless people felt in the face of the epidemic.

Neither physicians nor medicines were e� ective. Whether because these illnesses were previously unknown or because physicians had not previously studied them, there seemed to be no cure. There was such fear that nobody seemed to know what to do.

Source B

The Black Death The Black Death was an outbreak of the bubonic plague. The bacteria were carried in the bellies of fl eas who arrived in England on rats carried by merchant ships. It was probably spread by fl ea bites, although some recent evidence suggests that it was also spread in the air. The main symptom were buboes, which was swelling in the armpit or groin, fi lled with pus.

Once caught, it was unlikely that you would survive the disease. It usually killed its victims in three to fi ve days. At its height in London, 200 people were being buried every day. Contemporary accounts estimate that one million people died – more than a third of the population of England. Where the plague spread, it was common for more than half of a population of a town or city to die.

DraftDraft

This engraving from the 14th century shows somebody

Draft This engraving from the 14th century shows somebody


A person or thing that causes great su� ering.

Draft A person or thing that causes great su� ering.

DraftDraft In this extract from a report on the Black Death written

Draft In this extract from a report on the Black Death written in 1347, Italian chronicler Marchione di Coppo Stefani

Draftin 1347, Italian chronicler Marchione di Coppo Stefani

Draft Source B

Draft Source B


28

33


corruption to the body’s humours. People believed that this impure air may have originated from poisonous fumes released by an earthquake or a volcano.

Common beliefs For the everyday people living in the cities and countryside, the spread of the Black Death was terrifying and they would have heard many confl icting ideas about what caused it, including the ones above. In Europe, many people blamed the Jewish population, but the Jews had been expelled from England in the 13th century, so this was not the case in England.

Treatments of the Black Death Supernatural The main recommendation to treat the Black Death was to confess your sins, and ask God for forgiveness through prayer. However, there was an air of inevitability about the disease: once caught, people believed it was clearly God’s will; if it was his will that the patient should die, there was no cure that would work.

Natural To begin with, physicians tried bleeding and purging – the same things they would usually do to correct a humoural imbalance. Unfortunately, that didn’t work and, in fact, seemed to make people die more quickly.

As well as this, physicians recommended strong-smelling herbs like aloe and myrrh, which were believed to have cleansing properties. They o� en prescribed theriaca, as it was believed to work for lots of ailments. Lighting a fi re and boiling vinegar could also drive o� the bad air. Physicians or surgeons sometimes lanced the buboes – occasionally, people whose buboes burst survived.

Common beliefs Everyday people were willing to try anything to survive the Black Death. They held strong Christian beliefs, and so would have gone to confession and prayed, as well as seeking traditional cures like bleeding. However, it quickly became clear that neither priests nor physicians were capable of curing the disease.

Chest pains and breathing troubles

Boils and black buboesappearing in the groin

and armpits

Fever

Sneezing and coughingup blood

Symptoms ofBlack Death

Figure 1.6 Symptoms of the Black Death.

The Black Death is the name given by Victorian historians to the particular outbreak of the plague in 1348. A� er this, the plague returned every 10–20 years, although it killed fewer people with each subsequent outbreak.

People applied the same knowledge they had about the causes of disease and illness to the plague. New treatments appeared and advice on how to avoid catching the disease spread quickly.

Causes of the Black Death Religious and supernatural Many believed that the Black Death was the result of God deserting mankind – that is, the Black Death was a punishment for the sin in the world.

In 1345, there was an unusual positioning of the planets Mars, Jupiter and Saturn in the 14th degree of Aquarius, which astrologers interpreted as a sign that something wonderful or terrible was about to happen.

Natural causes The main natural cause attributed to the Black Death was the impure air. Breathing in this miasma caused

Draftwas to confess your sins, and ask God for forgiveness

Draftwas to confess your sins, and ask God for forgiveness through prayer. However, there was an air of inevitability

Draftthrough prayer. However, there was an air of inevitability about the disease: once caught, people believed it was

Draftabout the disease: once caught, people believed it was clearly God’s will; if it was his will that the patient should

Draftclearly God’s will; if it was his will that the patient should

The Black Death is the name given by Victorian historians Draft The Black Death is the name given by Victorian historians to the particular outbreak of the plague in 1348. A� er Draftto the particular outbreak of the plague in 1348. A� er this, the plague returned every 10–20 years, although it Draftthis, the plague returned every 10–20 years, although it


29

35


However, since the local government did not have a great deal of power at this time, they could not fully enforce these laws: rich people, for example, moved around quite freely and the Church continued to run as normal.

In groups of four, use the information above to create a television news report about the possible causes of the Black Death and what advice su� erers were given. One of you should play the part of a journalist, while the others take on the roles of priest, physician and an everyday person. Remember to give advice on both how to treat the disease and how to prevent it.

Activity

Writer Sean Martin shares his views, and those of other historians, on the impact of the Black Death in his book, A Short History of Disease (2015).

One immediate e� ect of the pandemic [an infectious disease spread across a large region] was the invention of quarantine. Historian GM Trevelyan argued that the Black Death was at least as important as the industrial revolution, while David Herlihy argued that the Black Death was “the great watershed”, [an important turning point] without which there would have been no Renaissance, and with no Renaissance, no industrial revolution.

Interpretation 1

The language of causation

Study these words and phrases. They are useful in describing the role of causes and how they are related to each other and to events.

motivated precondition prevented determined the timing

deepened the crisis

led to

exacerbated allowed triggered impeded catalyst developed

underlying created the potential infl uenced enabled accelerated sparked

1 Create a table with the following column headings: ‘word’, ‘meaning’, ‘timing’. Write out each word or phrase in a separate row of the ‘word’ column.

2 Discuss the meaning of each word or phrase with a partner. For each word or phrase, write a short defi nition in the ‘meaning’ column.

3 Is each word or phrase more likely to describe a short-term, medium-term or long-term cause? In the ‘timing’ column, write ‘short’, ‘medium’ or ‘long’.

4 Look at the following incomplete sentences. Write three versions of each sentence, using di� erent words and phrases from the table to complete them. You can add extra words to make the sentences work. For each sentence, decide which version is the best.

a The power of the Church …… the development of medical understanding.

b Following a regimen sanitatis …… the prevention of disease.

c The lack of medical understanding …… the spread of the Black Death.

5 You can also describe the importance of causes. Place the following words in order of importance. You should put words that suggest a cause is very important at the top, and words that suggest a cause is less important at the bottom of your list.

necessary contributed to added to marginal fundamental infl uenced supported negligible

THINKING HISTORICALLY Cause and Consequence

Because of the belief in bad air causing disease, the local authorities also stopped cleaning the streets. They believed that the foul stench of the rubbish and rotting bodies would drive o� the miasma causing the plague.

DraftDraftDraft

Study these words and phrases. They are useful in describing the role of causes and how they are related to each Draft Study these words and phrases. They are useful in describing the role of causes and how they are related to each Draft

DraftDraftDraft


34


Apothecaries sold remedies and herbs were mixed in the home, based on old recipes, but they had uncertain and unpredictable results. Nobody came up with a cure that defi nitely worked in all cases.

The lack of medical knowledge about what caused the disease meant it was impossible to know how to cure it.

Preventing the Black Death Supernatural means The main advice given by priests was for people to:

• pray to God and fast

• go on a pilgrimage and make o� erings to God

• show God how sorry you are by self-fl agellation (whipping yourself). Large groups of fl agellants wandered the streets of London, chanting and whipping themselves.

Natural means Escaping the plague was the best advice for prevention. Guy de Chauliac, who was the physician to the Pope, advised people to: ‘Go quickly, go far, and return slowly.’ It was essential to escape the foul air to stay healthy.

If this kind of movement was impossible, people believed it was essential to carry a posy of fl owers or fragrant herbs and hold it to your nose. This helped to avoid breathing in the miasma. Unlike the usual advice on preventing disease, people were advised to avoid bathing. It was believed that water would open the skin’s pores to the corrupted air.

Common beliefs One physician in Italy recommended doing joyful things, listening to cheerful music and avoiding anything sad as a protection against the disease. This is a clue as to just how desperate most physicians felt – they were willing to suggest anything to prevent their patients from catching the disease.

Much like the physicians, people did not know how to prevent the disease. However, they did stop visiting family members who had caught the plague – the common belief of the need to avoid those with the disease was so great that even their houses were avoided.

Government action Local authorities attempted to take action to prevent the plague from spreading. New quarantine* laws were put in place to try to stop people from moving around too much. People new to an area had to stay away from everybody else for 40 days, to ensure they were not carrying the disease. Authorities also started to quarantine houses where the plague had broken out. They considered banning preaching and religious processions, to stop large crowds of people gathering.

Quarantine*

Separating the sick and healthy to stop the spread of a disease. Those who are sick are not allowed to leave the quarantined area.

Key term

Draft Escaping the plague was the best advice for prevention. Guy de Chauliac,

Draft Escaping the plague was the best advice for prevention. Guy de Chauliac, who was the physician to the Pope, advised people to: ‘Go quickly, go far, and

Draftwho was the physician to the Pope, advised people to: ‘Go quickly, go far, and return slowly.’ It was essential to escape the foul air to stay healthy.

Draftreturn slowly.’ It was essential to escape the foul air to stay healthy.

Draft If this kind of movement was impossible, people believed it was essential to Draft If this kind of movement was impossible, people believed it was essential to carry a posy of fl owers or fragrant herbs and hold it to your nose. This helped Draftcarry a posy of fl owers or fragrant herbs and hold it to your nose. This helped to avoid breathing in the miasma. Unlike the usual advice on preventing Draftto avoid breathing in the miasma. Unlike the usual advice on preventing


30

35


However, since the local government did not have a great deal of power at this time, they could not fully enforce these laws: rich people, for example, moved around quite freely and the Church continued to run as normal.

In groups of four, use the information above to create a television news report about the possible causes of the Black Death and what advice su� erers were given. One of you should play the part of a journalist, while the others take on the roles of priest, physician and an everyday person. Remember to give advice on both how to treat the disease and how to prevent it.

Activity

Writer Sean Martin shares his views, and those of other historians, on the impact of the Black Death in his book, A Short History of Disease (2015).

One immediate e� ect of the pandemic [an infectious disease spread across a large region] was the invention of quarantine. Historian GM Trevelyan argued that the Black Death was at least as important as the industrial revolution, while David Herlihy argued that the Black Death was “the great watershed”, [an important turning point] without which there would have been no Renaissance, and with no Renaissance, no industrial revolution.

Interpretation 1

The language of causation

Study these words and phrases. They are useful in describing the role of causes and how they are related to each other and to events.

motivated precondition prevented determined the timing

deepened the crisis

led to

exacerbated allowed triggered impeded catalyst developed

underlying created the potential infl uenced enabled accelerated sparked

1 Create a table with the following column headings: ‘word’, ‘meaning’, ‘timing’. Write out each word or phrase in a separate row of the ‘word’ column.

2 Discuss the meaning of each word or phrase with a partner. For each word or phrase, write a short defi nition in the ‘meaning’ column.

3 Is each word or phrase more likely to describe a short-term, medium-term or long-term cause? In the ‘timing’ column, write ‘short’, ‘medium’ or ‘long’.

4 Look at the following incomplete sentences. Write three versions of each sentence, using di� erent words and phrases from the table to complete them. You can add extra words to make the sentences work. For each sentence, decide which version is the best.

a The power of the Church …… the development of medical understanding.

b Following a regimen sanitatis …… the prevention of disease.

c The lack of medical understanding …… the spread of the Black Death.

5 You can also describe the importance of causes. Place the following words in order of importance. You should put words that suggest a cause is very important at the top, and words that suggest a cause is less important at the bottom of your list.

necessary contributed to added to marginal fundamental infl uenced supported negligible

THINKING HISTORICALLY Cause and Consequence

Because of the belief in bad air causing disease, the local authorities also stopped cleaning the streets. They believed that the foul stench of the rubbish and rotting bodies would drive o� the miasma causing the plague.

DraftDraftDraft

Study these words and phrases. They are useful in describing the role of causes and how they are related to each Draft Study these words and phrases. They are useful in describing the role of causes and how they are related to each Draft

DraftDraftDraft


31

37

Recap: c1250–c1500: Medicine in medieval England

1 Give two reasons why people believed God sent diseases.

2 Name two important classical medical thinkers.

3 What were the Four Humours?

4 What had to happen to the Four Humours to cause disease?

5 Name two other things people in the period c1250–c1500 believed caused disease.

6 What was theriaca?

7 What was the name for advice on how to maintain a healthy lifestyle?

8 What was the main job of the apothecary?

9 Roughly how many hospitals were there in England by 1500?

10 How many people died during the fi rst outbreak of the plague in England?

Recall quiz

Cause

Treatment

Prevention

Little improvement, because of lack of scientific understanding and power of Church.

c1250–1500

How much we knew

Lack of knowledge of cause held back development of treatments that worked.

People sometimes knew what helped prevent disease, but they didn’t know why.

The progress table above shows the main areas of progress in this time period in cause , treatment and prevention . Using this table, make notes to explain why there was more knowledge about preventing diseases than explaining the causes and providing treatment, c1250–c1500.

Activity

Explain why there was little change in the care provided by hospitals in the period c1250–c1500.


• St Bartholomew’s Hospital in Smithfi eld

• people le� money for new hospitals in their wills.



It’s never too early to start timing your answers! A good rule of thumb is to allow yourself one and a half minutes per mark, which means you should spend about 40 minutes on the two questions above. You will need to both plan and write your answers in this time.

Exam tip

37

DraftDraftDraftDraftDraft

time.

Drafttime.

Draft


36


• Causes of the Black Death were thought to be supernatural – either as a result of alignment of the planets, a punishment from God or caused by a miasma.

• Treatments included prayer, strong-smelling herbs and herbal remedies.

• To begin with, physicians tried bleeding and purging, but this made the patient worse.

• Prevention was better than treatment: once you caught the Black Death, it was very likely that you would die.

• People tried to avoid catching the Black Death by avoiding infected family members or by leaving infected areas.

• The government tried to act by quarantining people.

Summary

Strengthen

S1 Draw a fl ow diagram to show how the Black Death spread and the impact it had on Britain.

S2 Name four treatments people used to try to cure the Black Death.

S3 List reasons why the local authorities were not very successful in the methods they used to try to halt the spread of the Black Death.

Challenge

C1 How did people’s beliefs about the causes of the Black Death, and ideas to prevent it, refl ect general ideas about the causes of illness and disease from the period c1250–c1500? Create a ‘Big picture, small detail’ chart to match up ideas. An example is shown below.

Prayer, fastingGod sent disease Prayer, fasting,pilgrimage,self-flagellation

The Black Death wasa punishment for sin

Big Picture –general beliefs

Small detail – beliefsabout the Black Death

Related treatment

Relatedprevention

How confi dent do you feel about your answers to these questions? Ask your teacher for some hints if you are stuck.

Checkpoint

DraftDraft

List reasons why the local authorities were not very successful in the methods they used to try to halt the

Draft List reasons why the local authorities were not very successful in the methods they used to try to halt the

How did people’s beliefs about the causes of the Black Death, and ideas to prevent it, refl ect general ideas

Draft How did people’s beliefs about the causes of the Black Death, and ideas to prevent it, refl ect general ideas about the causes of illness and disease from the period c1250–c1500? Create a ‘Big picture, small detail’ chart

Draftabout the causes of illness and disease from the period c1250–c1500? Create a ‘Big picture, small detail’ chart to match up ideas. An example is shown below. Draftto match up ideas. An example is shown below. Draft


Related DraftRelated


32

37

Recap: c1250–c1500: Medicine in medieval England

1 Give two reasons why people believed God sent diseases.

2 Name two important classical medical thinkers.

3 What were the Four Humours?

4 What had to happen to the Four Humours to cause disease?

5 Name two other things people in the period c1250–c1500 believed caused disease.

6 What was theriaca?

7 What was the name for advice on how to maintain a healthy lifestyle?

8 What was the main job of the apothecary?

9 Roughly how many hospitals were there in England by 1500?

10 How many people died during the fi rst outbreak of the plague in England?

Recall quiz

Cause

Treatment

Prevention

Little improvement, because of lack of scientific understanding and power of Church.

c1250–1500

How much we knew

Lack of knowledge of cause held back development of treatments that worked.

People sometimes knew what helped prevent disease, but they didn’t know why.

The progress table above shows the main areas of progress in this time period in cause , treatment and prevention . Using this table, make notes to explain why there was more knowledge about preventing diseases than explaining the causes and providing treatment, c1250–c1500.

Activity

Explain why there was little change in the care provided by hospitals in the period c1250–c1500.


• St Bartholomew’s Hospital in Smithfi eld

• people le� money for new hospitals in their wills.



It’s never too early to start timing your answers! A good rule of thumb is to allow yourself one and a half minutes per mark, which means you should spend about 40 minutes on the two questions above. You will need to both plan and write your answers in this time.

Exam tip

37

DraftDraftDraftDraftDraft

time.

Drafttime.

Draft


33

By the end of this lesson, you will understand how to:

• use key noun phrases from the question to make sure you are answering it

• use the subject-verb construction within a short statement sentence to clearly express an idea or opinion.

Learning outcomes

Noun: a word that names an object, idea, person, place, etc. (e.g. ‘Black Death’, ‘disease’, ‘town’).

Noun phrase: a phrase including a noun and any words that modify its meaning (e.g. ‘the king of England’).

Verb: words that describe actions (‘Galen developed a theory’), incidents (‘The disease spread ’) and situations (‘Galen’s theory lasted for centuries’).

Subject-verb construction: A noun or noun phrase (the subject of the clause) combined with a verb that tells you what the subject did or is doing.

Defi nitions

WRITINGH I S T O R I C A L LY

Writing historically: a clear response Every response you write needs to be clearly written. To help you achieve this, you need to clearly signal that your response is relevant to the question you are answering.

How can I make sure I am answering the question?

Look at this exam-style question in which key noun phrases and verbs are highlighted:

Explain why there was continuity in ideas about the cause of disease during the period c1250-c1500 . (12 marks)

Now look at the fi rst two sentences from two di� erent responses to this question below.

Answer A

Although the Church controlled medical learning, Galen’s ideas on the cause of disease were accepted. Galen’s ideas � tted in with the ideas of the Church.

Answer B

Galen developed the Theory of Opposites. He also believed in the idea of a soul.

1. a. Which answer signals most clearly that their response is going to answer the question?

b. Write a sentence or two explaining your choice.

2. Now look at this exam-style question:

Explain one way in which people’s reactions to the plague were similar in the 14th and 17th centuries. (4 marks)

a. Which are the key noun phrases and verbs in this question? Note them down.

b. Write the fi rst two sentences of your response to this question.

c. Look again at the fi rst two sentences of your response. Highlight all the key noun phrases and verbs from the question that you have included in your sentences. Have you used them all? If not, try rewriting your sentences, including them all to clearly signal that your response is answering the question.

DraftDraft

a theory’), incidents (‘The disease

Draft a theory’), incidents (‘The disease

A noun or noun phrase (the subject of the clause) combined with a verb

Draft A noun or noun phrase (the subject of the clause) combined with a verb

Draftthat tells you what the subject did or is doing.

Draftthat tells you what the subject did or is doing.

How can I make sure I am answering the question? Draft How can I make sure I am answering the question? Draft Look at this exam-style question in which key Draft Look at this exam-style question in which key

WH01_GCSE_History_Medicine_WH01_cpp.indd 38 15/03/2016 15:05

34

WRITINGH I S T O R I C A L LY

How can I clearly express my ideas?

One way to introduce your opinions and ideas clearly and briefl y is by using a short statement sentence beginning with a subject-verb construction.

Galen developed the Four Humours into the Theory of Opposites. His ideas were in harmony with those of the Church.

This is the main verb in this sentence. It tells you what Galen did.

This noun is the subject of the main verb. It tells you it was Galen that did it.

This is the main verb in this sentence. It tells you about the situation.

This noun is the subject of the main verb. It tells you who or what the verb refers to.

1. Look again at Answer A’s opening sentences:

Although the Church controlled medical learning, Galen’s ideas on the cause of disease were accepted. Galen’s ideas � tted in with the ideas of the Church.

This short statement sentence expresses the writer’s approach to the question clearly and briefl y.

This is the main verb in this sentence. This noun phrase is the subject of the sentence.

The writer could have written:

Because Galen’s ideas on the cause of disease � tted in with the ideas of the Church, who controlled medical learning, they were accepted.

or

Galen’s ideas on the cause of disease were accepted as they � tted in with the ideas of the Church, even though the Church controlled medical learning.

Which version do you prefer? Write a sentence or two explaining your choice.

2. a. Try rewriting the same information using di erent sentence structures to all the versions above.

b. Is your version clearer or more succinct than Answer A’s sentences?

Improving an answer

Look at this exam question:

Explain one way in which ideas about the treatment of disease were different in the 13th and 17th centuries. (4 marks)

Now look at one response to it:

Many people used herbal remedies. These were usually made with local plants and herbs such as mint and camomile. Recipes for these included theriaca, a popular remedy. More materials were available later due to increased overseas trading. New ingredients included nutmeg and cinnamon. There were also experiments with chemical cures, for example, the use of mercury to treat syphilis.

3. Rewrite the response so that:

a. the opening sentences focus on key words and phrases from the question

b. it includes a short statement sentence beginning with a subject-verb construction, to clearly introduce the writer’s approach to the question.

DraftDraft

This noun phrase is the subject of the sentence.

DraftThis noun phrase is the subject of the sentence.This noun phrase is the subject of the sentence.

DraftThis noun phrase is the subject of the sentence.

Draft Because Galen’s ideas on the cause of disease � tted in with the ideas of the Church, who

Draft Because Galen’s ideas on the cause of disease � tted in with the ideas of the Church, who controlled medical learning, they were accepted.

Draftcontrolled medical learning, they were accepted.

Draft Galen’s ideas on the cause of disease were accepted as they � tted in with the ideas of the Draft Galen’s ideas on the cause of disease were accepted as they � tted in with the ideas of the

WH01_GCSE_History_Medicine_WH01_cpp.indd 39 15/03/2016 15:05

35

Preparing for your exams

40


DraftDraftDraftDraftDraftDraft

Paper 1 overviewPaper 1 is in two sections that examine the Historic Environment and the Thematic Study. Together they count for 30% of your History assessment. The questions on the Thematic Study: ‘Medicine through time’ are in Section B and are worth 20% of your History assessment. Allow two-thirds of the examination time for Section B. There are an extra four marks for the assessment of Spelling, Punctuation and Grammar in the last question.

History Paper 1

Historic Environment and Thematic Depth Study

Time 1 hour 15 mins

Section A

Historic Environment

Answer 3 questions

16 marks

25 mins

Section B

Thematic Study

Answer 3 questions

32 marks+ 4 SPaG marks

50 mins

Medicine through time, c1250-presentYou need to answer Questions 3 and 4, and then either Question 5 or Question 6.

Q3 Explain one way… (4 marks)You are given about half a page of lines to write about a similarity or a di� erence. Allow fi ve minutes to write your answer. This question is only worth four marks and you should keep the answer brief. Only one comparison is needed. You should compare by referring to both periods given in the question – for example, ‘xxx was similar, because in the Middle Ages … and also in the 16th century …’

Q4 Explain why… (12 marks)This question asks you to explain the reasons why something happened. Allow about 15 minutes to write your answer. You are given two information points as prompts to help you. You do not have to use the prompts and you will not lose marks by leaving them out. Higher marks are gained by adding in a point extra to the prompts. You will be given at least two pages of lines in the answer booklet for your answer. This does not mean you should try to fi ll all the space. The front page of the exam paper states ‘there may be more space than you need’. Aim to write an answer giving at least three explained reasons.

EITHER 5 OR 6 How far do you agree? (16 marks +4 for SPaG)This question is worth 20 marks, including SPaG – more than half your marks for the whole of the Thematic Study. Make sure to keep 30 minutes of the exam time to answer it and to check your spelling, punctuation and grammar. You will have prompts to help, as for Question 4. You have a choice of questions: 5 or 6. Before you decide, be clear what the statement is about and what topic information will you need to answer it. The statement may be about one of the following concepts: signifi cance, cause, consequence, change, continuity, similarity, di� erence. It is a good idea during revision to practise identifying the concept focus of statements. You could do this with everyday examples and test one another: ‘The bus was late because it broke down’ = statement about cause; ‘The bus broke down as a result of poor maintenance’ = statement about consequence. ‘The bus service has improved recently’ = statement about change.You must make a judgement and you should think about both sides of the argument. Plan your answer before you begin to write and put your answer points in two columns, ‘For’ and ‘Against’. You should consider at least three points. Think about it as if you were putting weight on each side to decide what your judgement is going to be for the conclusion. That way, your whole answer hangs together – it is coherent. Be clear about your reasons (criteria) for your judgement – for example, why is one cause more important than another? Did it perhaps set others in motion? In this question, four extra marks will be gained for good spelling, punctuation and grammar. Use sentences, paragraphs, capital letters, commas and full stops, etc. Try also to use specialist terms specifi c to your Thematic Study – for example about society in the Middle Ages or the use of technology in the 20th century.

Preparing for your GCSE Paper 1 exam

On the one hand • Point 1

Conclusion

On the other hand • Point 2 • Point 3

Z01_GCSE_History_Medicine_EXP-cpp.indd 40 15/03/2016 15:0636

Each book has a section dedicated to explaining and exemplifying the new Edexcel GCSE (9–1) History exams. Advice on the demands of every paper, written by Angela Leonard, suggests ways students can successfully approach each exam. Each question type is then explained through annotated sample answers at two levels, showing clearly how answers can be improved.

41


Average answer

Herbal remedies such as mint and camomile were very common. Then there were more chemical cures, although they still used herbal remedies as well.

Explain one way in which ideas about the treatment of disease were di erent in the 13th and 17th centuries. (4 marks)

This answer identifi es treatments in each time period. There is some recognition of di� erence by using the word ‘then’. The answer does not specify time periods, so is vague. It lacks supporting examples.

This is an average answer because the candidate has provided general comments about the di� erence in treatment between the two time periods. Use the feedback to rewrite this answer, making as many improvements as you can.

Verdict

This answer should not be very long, but it does need to have specifi c information for each time period. Try to identify a di� erence between the two time periods, and then give a specifi c example for each one.

Exam tip

In the 13th century, many people were treated with herbal remedies. These were usually made with local plants and herbs such as mint and camomile. Recipes for these included theriaca, a popular remedy.Although herbal remedies were still used in the 17th century, more materials were available due to increased overseas trading. New ingredients included nutmeg and cinnamon. There were also experiments with chemical cures, for example, the use of mercury to treat syphilis.

This answer describes treatments in both centuries. It gives specifi c examples of treatments used and explains what the di� erence is and what caused it, using the wider context of trade.

This is a good answer because it features specifi c information about the topic to demonstrate the di� erence in treatments.

Verdict

Strong answer

6th

8th

DraftDraftDraftDraftDraftDraftDraft

This is an average answer because the candidate has provided general DraftThis is an average answer because the candidate has provided general This is an average answer because the candidate has provided general DraftThis is an average answer because the candidate has provided general

Paper 1, Question 3

Z01_GCSE_History_Medicine_EXP-cpp.indd 41 15/03/2016 15:06

40


DraftDraftDraftDraftDraftDraft

Paper 1 overviewPaper 1 is in two sections that examine the Historic Environment and the Thematic Study. Together they count for 30% of your History assessment. The questions on the Thematic Study: ‘Medicine through time’ are in Section B and are worth 20% of your History assessment. Allow two-thirds of the examination time for Section B. There are an extra four marks for the assessment of Spelling, Punctuation and Grammar in the last question.

History Paper 1

Historic Environment and Thematic Depth Study

Time 1 hour 15 mins

Section A

Historic Environment

Answer 3 questions

16 marks

25 mins

Section B

Thematic Study

Answer 3 questions

32 marks+ 4 SPaG marks

50 mins

Medicine through time, c1250-presentYou need to answer Questions 3 and 4, and then either Question 5 or Question 6.

Q3 Explain one way… (4 marks)You are given about half a page of lines to write about a similarity or a di� erence. Allow fi ve minutes to write your answer. This question is only worth four marks and you should keep the answer brief. Only one comparison is needed. You should compare by referring to both periods given in the question – for example, ‘xxx was similar, because in the Middle Ages … and also in the 16th century …’

Q4 Explain why… (12 marks)This question asks you to explain the reasons why something happened. Allow about 15 minutes to write your answer. You are given two information points as prompts to help you. You do not have to use the prompts and you will not lose marks by leaving them out. Higher marks are gained by adding in a point extra to the prompts. You will be given at least two pages of lines in the answer booklet for your answer. This does not mean you should try to fi ll all the space. The front page of the exam paper states ‘there may be more space than you need’. Aim to write an answer giving at least three explained reasons.

EITHER 5 OR 6 How far do you agree? (16 marks +4 for SPaG)This question is worth 20 marks, including SPaG – more than half your marks for the whole of the Thematic Study. Make sure to keep 30 minutes of the exam time to answer it and to check your spelling, punctuation and grammar. You will have prompts to help, as for Question 4. You have a choice of questions: 5 or 6. Before you decide, be clear what the statement is about and what topic information will you need to answer it. The statement may be about one of the following concepts: signifi cance, cause, consequence, change, continuity, similarity, di� erence. It is a good idea during revision to practise identifying the concept focus of statements. You could do this with everyday examples and test one another: ‘The bus was late because it broke down’ = statement about cause; ‘The bus broke down as a result of poor maintenance’ = statement about consequence. ‘The bus service has improved recently’ = statement about change.You must make a judgement and you should think about both sides of the argument. Plan your answer before you begin to write and put your answer points in two columns, ‘For’ and ‘Against’. You should consider at least three points. Think about it as if you were putting weight on each side to decide what your judgement is going to be for the conclusion. That way, your whole answer hangs together – it is coherent. Be clear about your reasons (criteria) for your judgement – for example, why is one cause more important than another? Did it perhaps set others in motion? In this question, four extra marks will be gained for good spelling, punctuation and grammar. Use sentences, paragraphs, capital letters, commas and full stops, etc. Try also to use specialist terms specifi c to your Thematic Study – for example about society in the Middle Ages or the use of technology in the 20th century.

Preparing for your GCSE Paper 1 exam

On the one hand • Point 1

Conclusion

On the other hand • Point 2 • Point 3

Z01_GCSE_History_Medicine_EXP-cpp.indd 40 15/03/2016 15:06 37

Like what you see in the Student Books?There’s even more available online...

• Editable lesson plans you can tailor to your studentsü Linked to the Edexcel schemes of work ü Filled with differentiation ideas to engage all your students with history

• Online Student Books (ActiveBooks) to use with your classesü Include zoomable sources, images and activities, perfect for front-of-class teachingü Embedded teaching and learning resources to inspire your lessons, such as video

introductions and source materials for the Historic Environment unit

• Ready-made student worksheetsü Designed to complement the Student Books and lesson plansü Editable, so you can personalise them to your students’ needs

• Extra materials for Thinking Historically and Writing Historically ü Teacher notes to help you use the Student Books’ ‘Thinking Historically’ and

‘Writing Historically’ pedagogies with your classesü Additional worksheets to support your students as they develop their conceptual

understanding and historical literacy skills

• Assessment materials to help your students get set for the new examsü Exam skills PowerPoints with exam questions and sample answersü Realistic exam-style assessments and mark schemes for each unit – ideal

for exam practiceü Diagnostic assessments linked to the Pearson Progression Scale to help

you and your students pinpoint strengths and weaknesses

NEW

for t

he 2016

specificatio

n

ActiveLearn Digital Service

.

We’ve created a whole host of time-saving digital tools and materials to help you plan, teach, track and assess the new Edexcel GCSE (9–1) qualification with confidence.

Sign up to hear more at www.pearsonschools.co.uk/HistOnline2016.38

Like what you see in the Student Books?There’s even more available online...

Track your students’ progress with the Pearson Progression Services

• A progression scale to track students’ progress in history, divided into steps of increasing demand. For ages 11–16 we have created 12 steps from low to high performance. In most subjects, expected average progress for a student is one step per year.

In this example, a student starting on step 4 at the start of Year 7 will be expected to be on step 9 at the end of Year 11.

• A progression map representing our view of how learning progresses in history, and how understanding and skills build upon each other.

• Tests mapped to the scale and reporting in steps. You can also use the scale for your own assessments.

• An online markbook to help predict future performance, quickly identify problems, take the most effective actions, and compare student progress nationally.

.

Sign up to hear more at www.pearsonschools.co.uk/HistOnline2016.

Steps Transition 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th

Example of expected progress from Years 7 – 11

39

Download a free, ready-made and editable Progression Scale and Map at

www.pearsonschools.co.uk/HistoryProgress2016.

Photo credits:French. Picture credits: Fotolia.com: DragonImages 11 (8L), Hurricane 11 (8R); Pearson Education Ltd: Jules Selmes 11 (8C); Shutterstock.com: CREATISTA 11t. Cover images: Front: Alamy / kevers C746WN (RF)

V403

Get set for September and save!

35% off our GCSE (9–1) History Student Bookswith code GCSEHIS16*

www.pearsonschools.co.uk/Hist35.

Cover image: Science Photo Library: Sheila Terry

Pearson Ltd is committed to reducing its impact on the environment by using responsibly sourced and recycled paper.

This leaflet is printedon 75% recycled paper

When you have finished withthis leaflet please recycle it

*Valid until 31st May 2016. Only available to those purchasing on a UK establishment account and not to be combined with any other offers.

Documents

History - Pearson Educationassets.pearsonschool.com/...GCSE-(9-1)-History...Pearson’s brand-new resources* for Edexcel GCSE (9–1) History are designed to help all your students